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General NPI Number Information
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NPI Number | 1043682685
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Entity Type | Individual
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Provider Name | CHRISTIANA N IKOME NP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 600 REISTERSTOWN RD STE 302
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City | PIKESVILLE
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State | MD
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Zip | 21208-5106
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Country | US
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Telephone | 301-792-1433
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Fax | 443-241-7250
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Provider Business Mailing Address
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Address Line | 10823 SHERWOOD HILL RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5826
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Country | US
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Telephone | 301-792-1433
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R189380
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R189380
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | R189380
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R189380
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License Number State | MD
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