Healthcare Provider Details

I. General information

NPI: 1598638884
Provider Name (Legal Business Name): MARIA ALONDRA ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FOXCROFT AVE STE 101
MARTINSBURG WV
25401-5302
US

IV. Provider business mailing address

104 EQUINOX WAY E
MARTINSBURG WV
25401-1845
US

V. Phone/Fax

Practice location:
  • Phone: 304-443-1408
  • Fax:
Mailing address:
  • Phone: 304-901-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025048000
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: