Provider Demographics
NPI:1558083493
Name:EZEIBE, AMAKA ONYEKA
Entity type:Individual
Prefix:
First Name:AMAKA
Middle Name:ONYEKA
Last Name:EZEIBE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 FALLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3451
Mailing Address - Country:US
Mailing Address - Phone:202-714-0981
Mailing Address - Fax:
Practice Address - Street 1:3134 FALLSTON AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3451
Practice Address - Country:US
Practice Address - Phone:202-714-0981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200002251374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide