Provider Demographics
NPI:1386414480
Name:NDELLE, DYMPNA (NP)
Entity type:Individual
Prefix:
First Name:DYMPNA
Middle Name:
Last Name:NDELLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 SENEY LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5927
Mailing Address - Country:US
Mailing Address - Phone:410-805-7816
Mailing Address - Fax:410-832-3921
Practice Address - Street 1:9300 SENEY LN
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5927
Practice Address - Country:US
Practice Address - Phone:410-805-7816
Practice Address - Fax:410-832-3921
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health