Healthcare Provider Details

I. General information

NPI: 1972435816
Provider Name (Legal Business Name): LINDA OBIAGELI EKEINDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

9214 GREENSIDE LNDG
LAUREL MD
20723-2090
US

IV. Provider business mailing address

9214 GREENSIDE LNDG
LAUREL MD
20723-2090
US

V. Phone/Fax

Practice location:
  • Phone: 301-476-3065
  • Fax: 301-476-3065
Mailing address:
  • Phone: 301-476-3065
  • Fax: 301-476-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR240471
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: