Provider Demographics
NPI:1154896629
Name:EBIRINGA, MALINDA AMARACHI
Entity type:Individual
Prefix:
First Name:MALINDA
Middle Name:AMARACHI
Last Name:EBIRINGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4966
Mailing Address - Country:US
Mailing Address - Phone:240-486-1583
Mailing Address - Fax:
Practice Address - Street 1:4013 DAVID DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4966
Practice Address - Country:US
Practice Address - Phone:240-486-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX750862163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse