Provider Demographics
NPI:1568824043
Name:NNEBEDUM, BEDE IKPECHUKWU (RN)
Entity Type:Individual
Prefix:
First Name:BEDE
Middle Name:IKPECHUKWU
Last Name:NNEBEDUM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10706 BIRDIE LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6019
Mailing Address - Country:US
Mailing Address - Phone:240-374-2907
Mailing Address - Fax:202-291-7018
Practice Address - Street 1:7506 GEORGIA AVE, NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1608
Practice Address - Country:US
Practice Address - Phone:202-291-6973
Practice Address - Fax:202-291-7018
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1004106164W00000X
DCRN200002412163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse