Healthcare Provider Details

I. General information

NPI: 1689215527
Provider Name (Legal Business Name): ELSHADAY TEFERI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 MCGAW RD STE 350-360
COLUMBIA MD
21045-4743
US

IV. Provider business mailing address

8890 MCGAW RD STE 350-360
COLUMBIA MD
21045-4743
US

V. Phone/Fax

Practice location:
  • Phone: 301-317-6575
  • Fax:
Mailing address:
  • Phone: 301-317-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC004747
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024178141
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC002925
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: