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General NPI Number Information
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NPI Number | 1730565599
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Entity Type | Individual
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Provider Name | ELIZABETH EBEI NDIKA CRNP/ FNP-C, PMHNP-
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 14333 LAUREL BOWIE RD STE 204
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City | LAUREL
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State | MD
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Zip | 20708-1179
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Country | US
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Telephone | 240-241-4989
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Fax | 301-477-1976
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Provider Business Mailing Address
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Address Line | 14333 LAUREL BOWIE RD STE 204
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City | LAUREL
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State | MD
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Zip | 20708-1179
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Country | US
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Telephone | 240-241-4989
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Fax | 301-477-1976
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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 | R151225
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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 | R151225
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License Number State | MD
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