Provider Demographics
NPI:1255690814
Name:EZEAKACHA, FRANCA IFEOMA
Entity Type:Individual
Prefix:
First Name:FRANCA
Middle Name:IFEOMA
Last Name:EZEAKACHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 67TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1761
Mailing Address - Country:US
Mailing Address - Phone:240-421-7562
Mailing Address - Fax:
Practice Address - Street 1:6013 67TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1761
Practice Address - Country:US
Practice Address - Phone:240-421-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCRN1037494163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide