Provider Demographics
NPI:1548805120
Name:EZEANI, ESTHER IFEOMA (NP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:IFEOMA
Last Name:EZEANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3908 ESGARTH WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1230
Mailing Address - Country:US
Mailing Address - Phone:410-409-2652
Mailing Address - Fax:410-549-7354
Practice Address - Street 1:1380 PROGRESS WAY STE 102
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6498
Practice Address - Country:US
Practice Address - Phone:410-795-0257
Practice Address - Fax:410-549-7354
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2024-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR228757363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily