Provider Demographics
NPI:1053679571
Name:EGEBE, NEVILLE
Entity Type:Individual
Prefix:
First Name:NEVILLE
Middle Name:
Last Name:EGEBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 NEW YORK AVE
Mailing Address - Street 2:SUITE 117 GLOBAL HEALTHCARE INC.
Mailing Address - City:NE
Mailing Address - State:DC
Mailing Address - Zip Code:20002
Mailing Address - Country:US
Mailing Address - Phone:202-480-0813
Mailing Address - Fax:202-503-2363
Practice Address - Street 1:1818 NEW YORK AVE
Practice Address - Street 2:SUITE 117 GLOBAL HEALTHCARE INC.
Practice Address - City:NE
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-480-0813
Practice Address - Fax:202-503-2363
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCRN1046073163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty