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General NPI Number Information
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NPI Number | 1447732441
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Entity Type | Individual
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Provider Name | EDMOND ROSTAND MUSOM NSHEUKO
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Gender | Male
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 11921 ROCKVILLE PIKE STE 402
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City | ROCKVILLE
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State | MD
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Zip | 20852-2757
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Country | US
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Telephone | 571-977-6870
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Fax |
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Provider Business Mailing Address
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Address Line | 6218 MONTROSE RD
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City | ROCKVILLE
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State | MD
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Zip | 20852-4119
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Country | US
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Telephone | 703-841-1290
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Fax | 301-255-0110
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R194343
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024184303
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R194343
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License Number State | MD
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