Provider Demographics
NPI:1427756584
Name:BILLY-EKO, EVLYN ESIET (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:EVLYN
Middle Name:ESIET
Last Name:BILLY-EKO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1411
Mailing Address - Country:US
Mailing Address - Phone:301-651-1318
Mailing Address - Fax:
Practice Address - Street 1:5602 BALTIMORE NATIONAL PIKE STE 507
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1403
Practice Address - Country:US
Practice Address - Phone:443-870-4608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR199960Medicaid