Healthcare Provider Details

I. General information

NPI: 1831713023
Provider Name (Legal Business Name): GIDEON EKE DNP, MSN, BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 PHILADELPHIA RD
JOPPA MD
21085-3216
US

IV. Provider business mailing address

1518 PHILADELPHIA RD
JOPPA MD
21085-3216
US

V. Phone/Fax

Practice location:
  • Phone: 410-538-4825
  • Fax: 410-538-5510
Mailing address:
  • Phone: 410-538-4625
  • Fax: 410-538-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR124712
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: