Provider Demographics
NPI:1881340677
Name:PARKER WAUGH, EBONY CECILIA (DNP, MSN, RN)
Entity type:Individual
Prefix:DR
First Name:EBONY
Middle Name:CECILIA
Last Name:PARKER WAUGH
Suffix:
Gender:F
Credentials:DNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 BANDERA ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2411
Mailing Address - Country:US
Mailing Address - Phone:404-218-3208
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 330C
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4795
Practice Address - Country:US
Practice Address - Phone:443-399-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210042163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse