Provider Demographics
NPI:1831688985
Name:EZEMOBI, JOSEPHINE NKECHINYERE (FNP)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:NKECHINYERE
Last Name:EZEMOBI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 FESTIVAL CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3170
Mailing Address - Country:US
Mailing Address - Phone:301-503-4124
Mailing Address - Fax:301-503-4124
Practice Address - Street 1:1275 PENNSYLVANIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004-2404
Practice Address - Country:US
Practice Address - Phone:202-638-4583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1023962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily