Provider Demographics
NPI:1861218760
Name:AL-AMEEN, ISLAMMIYYAH B (RN,CPRP,PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ISLAMMIYYAH
Middle Name:B
Last Name:AL-AMEEN
Suffix:
Gender:F
Credentials:RN,CPRP,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3813
Mailing Address - Country:US
Mailing Address - Phone:410-988-2655
Mailing Address - Fax:
Practice Address - Street 1:226 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3813
Practice Address - Country:US
Practice Address - Phone:410-988-2655
Practice Address - Fax:410-988-2626
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2025-04-21
Deactivation Date:2024-11-27
Deactivation Code:
Reactivation Date:2024-12-05
Provider Licenses
StateLicense IDTaxonomies
MDR220837363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health