Provider Demographics
NPI:1376266825
Name:EGHAGHE, JOY O (CRNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:O
Last Name:EGHAGHE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 PAHLS FARM WAY
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5852
Mailing Address - Country:US
Mailing Address - Phone:443-454-4802
Mailing Address - Fax:
Practice Address - Street 1:7201 PAHLS FARM WAY
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5852
Practice Address - Country:US
Practice Address - Phone:443-454-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD231836363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health