Provider Demographics
NPI:1437844826
Name:EFEYINI, GRACE ONYEKACHI (AGPCNP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ONYEKACHI
Last Name:EFEYINI
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ONYEKACHI
Other - Last Name:EFEYINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGPCNP
Mailing Address - Street 1:PO BOX 43434
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-0434
Mailing Address - Country:US
Mailing Address - Phone:443-777-6166
Mailing Address - Fax:
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:410-812-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217615363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology