Provider Demographics
NPI:1316781537
Name:EBE, CHIKODIRI (DNP,MS,MSN, PMHNP)
Entity type:Individual
Prefix:DR
First Name:CHIKODIRI
Middle Name:
Last Name:EBE
Suffix:
Gender:F
Credentials:DNP,MS,MSN, PMHNP
Other - Prefix:DR
Other - First Name:CHIKODIRI
Other - Middle Name:
Other - Last Name:EBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP,MS,MSN, PMHNP
Mailing Address - Street 1:200 MAY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-5520
Mailing Address - Country:US
Mailing Address - Phone:774-535-7712
Mailing Address - Fax:
Practice Address - Street 1:200 MAY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-5520
Practice Address - Country:US
Practice Address - Phone:508-403-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2295580363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health