Healthcare Provider Details

I. General information

NPI: 1942561113
Provider Name (Legal Business Name): JUBILYN AKARAGWE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9863 GOOD LUCK RD
LANHAM MD
20706-3212
US

IV. Provider business mailing address

9863 GOOD LUCK RD
LANHAM MD
20706-3212
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-5806
  • Fax:
Mailing address:
  • Phone: 240-413-5806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0021157
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1175070
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: