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General NPI Number Information
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NPI Number | 1790088557
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Entity Type | Individual
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Provider Name | KATHERINE EYEGUE-SANDY CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 06/29/2025
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Provider Practice Location Address
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Address Line | 6480 NEW HAMPSHIRE AVE STE 301
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4716
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Country | US
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Telephone | 240-978-5655
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Fax | 276-248-0224
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Provider Business Mailing Address
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Address Line | 6480 NEW HAMPSHIRE AVE STE 301
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4716
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Country | US
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Telephone | 240-978-5655
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Fax | 276-248-0224
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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 | NP1047436
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP010912
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License Number State | PA
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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 | 226978
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License Number State | AK
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