Provider Demographics
NPI:1184515728
Name:EGHBALI, ORA (RN-BSN)
Entity type:Individual
Prefix:
First Name:ORA
Middle Name:
Last Name:EGHBALI
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5540
Mailing Address - Country:US
Mailing Address - Phone:410-871-3005
Mailing Address - Fax:443-293-8711
Practice Address - Street 1:450 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5540
Practice Address - Country:US
Practice Address - Phone:410-871-3005
Practice Address - Fax:443-293-8711
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166981163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)