DWAYNE OMAR ENNIS PMHNP-BC NPI 1700607835

NPI Information

  • NPI: 1700607835
  • Provider Name: DWAYNE OMAR ENNIS, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 100 HOSPITAL RD
    PRINCE FREDERICK, MD
    ZIP 20678
  • Phone: (917) 560-5145

Map and Directions

Get Directions

NPI Details

Dwayne Omar Ennis, PMHNP-BC is a psychiatric/mental health nurse practitioner in Prince Frederick, MD. Dwayne Omar Ennis, PMHNP-BC NPI is 1700607835. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 HOSPITAL RD
PRINCE FREDERICK, MD
ZIP 20678-017
Phone: (917) 560-5145

The enumeration date for this NPI number is 10/21/2024 and was last updated on 10/21/2024.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthR173805MARYLANDYes

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.