Provider Demographics
NPI:1780933739
Name:EBIRINGA, BERNICE (LPN)
Entity type:Individual
Prefix:MS
First Name:BERNICE
Middle Name:
Last Name:EBIRINGA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 HILLVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4841
Mailing Address - Country:US
Mailing Address - Phone:301-336-3280
Mailing Address - Fax:
Practice Address - Street 1:8404 HILLVIEW RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4841
Practice Address - Country:US
Practice Address - Phone:301-336-3280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP38765164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse