Provider Demographics
NPI:1174934459
Name:KWAVEN, ROSEMARY BIMERU (PMHNP)
Entity type:Individual
Prefix:MISS
First Name:ROSEMARY
Middle Name:BIMERU
Last Name:KWAVEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6353 64TH AVE APT A1
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1501
Mailing Address - Country:US
Mailing Address - Phone:571-276-6982
Mailing Address - Fax:
Practice Address - Street 1:16320 EAGLE FLIGHT CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6080
Practice Address - Country:US
Practice Address - Phone:571-276-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10332171M00000X
VA00241849232084P0800X
DCCN210136038363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry