Provider Demographics
NPI:1548735525
Name:SARMIENTO, NELIA (PA, PMHNP)
Entity type:Individual
Prefix:
First Name:NELIA
Middle Name:
Last Name:SARMIENTO
Suffix:
Gender:F
Credentials:PA, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9728 HICKORYHURST DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4813
Mailing Address - Country:US
Mailing Address - Phone:443-977-4808
Mailing Address - Fax:410-413-7029
Practice Address - Street 1:120 SISTER PIERRE DR STE 501
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7527
Practice Address - Country:US
Practice Address - Phone:443-977-4808
Practice Address - Fax:410-413-7029
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR164517363LP0808X
MD1156633363AM0700X, 2084P0800X
1156633363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant