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NPI Code Detail

MEDICARE: EZINWANNE JUDITH IROBEREACHI

MEDICARE:   EZINWANNE JUDITH IROBEREACHI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR182841MD

General Provider Information

NPI Number : 1184221236
Entity Type Code : Individual
Provider Name (Legal Business Name) : EZINWANNE JUDITH IROBEREACHI
Provider Business Mailing Address
First Line : 15802 PACIFIC CT
Second Line :
City : BOWIE
State : MD
Zip : 20716-1632
Country : US
Telephone Number : 301-377-9313
Fax Number :
Provider Business Practice Location Address
First Line : 2203 PHILADELPHIA RD
Second Line :
City : EDGEWOOD
State : MD
Zip : 21040-1109
Country : US
Telephone Number : 410-612-0275
Fax Number : 410-612-0287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2020
Last Update Date : 02/02/2023

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Directions to “ EZINWANNE JUDITH IROBEREACHI ” Practice Location

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