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General NPI Number Information
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NPI Number | 1790251106
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Entity Type | Individual
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Provider Name | MMACHUKWU BLESSING EMUKA
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 1298 CRONSON BLVD STE 203
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City | CROFTON
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State | MD
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Zip | 21114-2035
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Country | US
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Telephone | 410-451-2273
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Fax | 877-734-3432
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Provider Business Mailing Address
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Address Line | 1298 CRONSON BLVD STE 203
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City | CROFTON
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State | MD
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Zip | 21114-2035
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Country | US
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Telephone | 410-451-2273
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Fax | 877-734-3432
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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 | R176418
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License Number State | MD
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