Provider Demographics
NPI:1598588964
Name:EWUSIE, ISABELLA (NP)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:EWUSIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ISABELLA
Other - Middle Name:
Other - Last Name:ANSAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:23409 HARNESS POINT WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4049
Mailing Address - Country:US
Mailing Address - Phone:240-671-6249
Mailing Address - Fax:
Practice Address - Street 1:23409 HARNESS POINT WAY
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4049
Practice Address - Country:US
Practice Address - Phone:240-671-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health