Healthcare Provider Details

I. General information

NPI: 1417380676
Provider Name (Legal Business Name): FRANCIEL J IKEJI RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 KIMBLEWICK DR
SILVER SPRING MD
20904-6320
US

IV. Provider business mailing address

404 KIMBLEWICK DR
SILVER SPRING MD
20904-6320
US

V. Phone/Fax

Practice location:
  • Phone: 214-284-5787
  • Fax:
Mailing address:
  • Phone: 214-284-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: