KHADEJA QUBLA IBN BAIDOO CRNP NPI 1104467414

NPI Information

NPI: 1104467414
Provider Name: KHADEJA QUBLA IBN BAIDOO, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: OPAL MEDICAL GROUP PA

PECOS Registration: Yes

Address:
4843 MARSDEN PL
FREDERICK, MD
ZIP 21703
Phone: (571) 275-6765
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Khadeja Qubla Ibn Baidoo, CRNP is a family nurse practitioner in Frederick, MD with 5 years of experience. Khadeja Qubla Ibn Baidoo, CRNP NPI is 1104467414. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4843 MARSDEN PL
FREDERICK, MD
ZIP 21703-822
Phone: (571) 275-6765

The NPI 1104467414 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/8/2019 and was last updated on 6/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		R214238	MARYLAND	No
2	363LF0000X	Nurse Practitioner	Family	R214238	MARYLAND	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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