Provider Demographics
NPI:1285258541
Name:EKE, PETRONILLA (BSN,RN)
Entity type:Individual
Prefix:DR
First Name:PETRONILLA
Middle Name:
Last Name:EKE
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3216
Mailing Address - Country:US
Mailing Address - Phone:410-538-4825
Mailing Address - Fax:
Practice Address - Street 1:1520 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3216
Practice Address - Country:US
Practice Address - Phone:410-538-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility