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NPI Code Detail

MEDICARE: EVARISTUS KOBI NDI RN

MEDICARE: EVARISTUS KOBI NDI RN
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
1163WH0200XHome Health Registered NurseRN1017603DC

General Provider Information

NPI Number : 1245758523
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVARISTUS KOBI NDI RN
Provider Business Mailing Address
First Line : 3512 CHERRYVALE DR
Second Line :
City : BELTSVILLE
State : MD
Zip : 20705-3837
Country : US
Telephone Number : 240-701-6588
Fax Number :
Provider Business Practice Location Address
First Line : 3512 CHERRYVALE DR
Second Line :
City : BELTSVILLE
State : MD
Zip : 20705-3837
Country : US
Telephone Number : 240-701-6588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2017
Last Update Date : 07/21/2022

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