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General NPI Number Information
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NPI Number | 1801407028
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Entity Type | Individual
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Provider Name | NGOZI MARTHA EBOH FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW # 2HICU
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 202-877-7753
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 ORA GLEN DR UNIT 1224
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City | GREENBELT
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State | MD
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Zip | 20768-7562
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Country | US
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Telephone | 301-351-5615
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R170965
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | RN1007255
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License Number State | DC
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