Healthcare Provider Details

I. General information

NPI: 1275291346
Provider Name (Legal Business Name): NKECHINYERE MELINDA ESEMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 06/06/2022
Certification Date: 06/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 19TH AVE
SAN FRANCISCO CA
94116-1250
US

IV. Provider business mailing address

4555 WISCONSIN AVE NW
WASHINGTON DC
20016-4619
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 202-537-1587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95017091
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP5000003116
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: