Provider Demographics
NPI:1134781875
Name:JUMA, EDWIN O (CRNP)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:O
Last Name:JUMA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3038 MITCHELLVILLE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1383
Mailing Address - Country:US
Mailing Address - Phone:757-667-9549
Mailing Address - Fax:
Practice Address - Street 1:3038 MITCHELLVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1372
Practice Address - Country:US
Practice Address - Phone:301-809-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR206363163WC0200X
MDAG07190058363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology