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NPI Code Detail

MEDICARE: BARBARA KEIKO MCCUBBIN NP-C

MEDICARE: BARBARA KEIKO MCCUBBIN NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN961677DC

General Provider Information

NPI Number : 1497221345
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA KEIKO MCCUBBIN NP-C
Provider Business Mailing Address
First Line : 9600 PULASKI PARK DR STE 103
Second Line :
City : BALTIMORE
State : MD
Zip : 21220-1472
Country : US
Telephone Number : 443-725-8737
Fax Number : 443-725-8816
Provider Business Practice Location Address
First Line : 228 7TH ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-4306
Country : US
Telephone Number : 202-698-0795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2018
Last Update Date : 10/18/2018

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