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General NPI Number Information
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NPI Number | 1649920216
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Entity Type | Individual
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Provider Name | GIDEON ESUZOR
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Gender | Male
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Dates
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Enumeration Date | 03/26/2022
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2300 PENNSYLVANIA AVE UNIT LLC
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City | WILMINGTON
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State | DE
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Zip | 19806-1392
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Country | US
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Telephone | 302-213-6158
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Fax | 855-530-2764
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Provider Business Mailing Address
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Address Line | 13603 WHITE BARN LN
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City | HERNDON
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State | VA
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Zip | 20171-3341
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Country | US
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Telephone | 404-788-2882
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN190476
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License Number State | GA
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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 | 0024189217
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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 | AC006300
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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 | L8-0010781
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License Number State | DE
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