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NPI Code Detail

MEDICARE: LUCY EYOMBO EKASSI NP

MEDICARE: LUCY EYOMBO EKASSI NP
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
1363LF0000XFamily Nurse PractitionerR139691MD

General Provider Information

NPI Number : 1902675978
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCY EYOMBO EKASSI NP
Provider Business Mailing Address
First Line : 13213 5TH ST
Second Line :
City : BOWIE
State : MD
Zip : 20720-3609
Country : US
Telephone Number : 301-806-6986
Fax Number :
Provider Business Practice Location Address
First Line : 2501 MUSGROVE RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-7128
Country : US
Telephone Number : 301-890-5552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2024
Last Update Date : 01/01/2024

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