Provider Demographics
NPI:1497339386
Name:EFEMWONYI F JESUOROBO
Entity Type:Organization
Organization Name:EFEMWONYI F JESUOROBO
Other - Org Name:HIS & HER MEDICAL AND MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:EFEMWONYI
Authorized Official - Middle Name:F
Authorized Official - Last Name:JESUOROBO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC, PMHNP-B
Authorized Official - Phone:202-368-6707
Mailing Address - Street 1:6196 OXON HILL RD STE 290
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3141
Mailing Address - Country:US
Mailing Address - Phone:240-493-7847
Mailing Address - Fax:240-493-7327
Practice Address - Street 1:6196 OXON HILL RD STE 290
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3141
Practice Address - Country:US
Practice Address - Phone:240-493-7847
Practice Address - Fax:240-493-7327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty