Healthcare Provider Details

I. General information

NPI: 1497234819
Provider Name (Legal Business Name): AGNES SENZE EKITI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 RIVA RD
ANNAPOLIS MD
21401-7304
US

IV. Provider business mailing address

2601 RIVA RD
ANNAPOLIS MD
21401-7304
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1025057
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR197158
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: