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General NPI Number Information
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NPI Number | 1760398564
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Entity Type | Organization
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Legal Business Name | J RAPHA CLINIC LLC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 4602 GLADYS CT
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City | LANHAM
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State | MD
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Zip | 20706-1978
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Country | US
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Telephone | 202-492-4621
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Fax |
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Provider Business Mailing Address
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Address Line | 15630 OLD COLUMBIA PIKE STE E
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1617
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Country | US
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Telephone | 202-492-4621
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NP
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Name | MMACHUKWU BLESSING EMUKA
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Credential | APRN
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Telephone | 202-492-4620
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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 |
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License Number State |
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