Healthcare Provider Details

I. General information

NPI: 1649794090
Provider Name (Legal Business Name): LORETA EKWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11207 CHAMPLAIN CIR
BOWIE MD
20720-3490
US

IV. Provider business mailing address

7715 RIVERDALE RD APT 303
NEW CARROLLTON MD
20784-3943
US

V. Phone/Fax

Practice location:
  • Phone: 240-821-3273
  • Fax:
Mailing address:
  • Phone: 240-821-3273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA12793
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: