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General NPI Number Information
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NPI Number | 1033815790
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Entity Type | Individual
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Provider Name | ETHEL ESUMA ELAD NP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 9470 ANNAPOLIS RD
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City | LANHAM
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State | MD
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Zip | 20706-3025
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Country | US
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Telephone | 202-499-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 7972 POTTER PL
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City | ELKRIDGE
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State | MD
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Zip | 21075-8226
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Country | US
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Telephone | 301-793-0468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP500007113
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License Number State | DC
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