Provider Demographics
NPI:1306574819
Name:EGBE NJIKAM, CAROLINA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:EGBE NJIKAM
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FREEDOM BUSINESS CTR DR STE 300-3756
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1331
Mailing Address - Country:US
Mailing Address - Phone:267-471-6240
Mailing Address - Fax:
Practice Address - Street 1:630 FREEDOM BUSINESS CTR DR STE 300-3756
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1331
Practice Address - Country:US
Practice Address - Phone:267-471-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025650363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty