Provider Demographics
NPI:1346973062
Name:MAKINDE, EPHRAIM AKIN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EPHRAIM
Middle Name:AKIN
Last Name:MAKINDE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8508 OKEEFE DR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3136
Mailing Address - Country:US
Mailing Address - Phone:240-421-1251
Mailing Address - Fax:
Practice Address - Street 1:8508 OKEEFE DR
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-3136
Practice Address - Country:US
Practice Address - Phone:240-421-1251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-09
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223835363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health