Provider Demographics
NPI:1841823523
Name:IJAJA, REGINA EJURA (NP)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:EJURA
Last Name:IJAJA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2338
Mailing Address - Country:US
Mailing Address - Phone:202-372-7755
Mailing Address - Fax:
Practice Address - Street 1:7203 HANOVER PKWY STE B
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2000
Practice Address - Country:US
Practice Address - Phone:240-391-6730
Practice Address - Fax:188-850-2320
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191611163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse