Provider Demographics
NPI:1760235212
Name:NYEMA, GEORGE CALVIN SR (CRNP)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:CALVIN
Last Name:NYEMA
Suffix:SR
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 MALCOLM DR STE A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6130
Mailing Address - Country:US
Mailing Address - Phone:443-821-0717
Mailing Address - Fax:
Practice Address - Street 1:419 MALCOLM DR STE A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6130
Practice Address - Country:US
Practice Address - Phone:443-821-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206088363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health