Provider Demographics
NPI:1992245930
Name:EZEKEGBO, ANULIKA UKAMAKA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ANULIKA
Middle Name:UKAMAKA
Last Name:EZEKEGBO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6939 LAMONT DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4606
Mailing Address - Country:US
Mailing Address - Phone:301-792-5316
Mailing Address - Fax:
Practice Address - Street 1:6939 LAMONT DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4606
Practice Address - Country:US
Practice Address - Phone:301-792-5316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR138442363LF0000X
DCRN66653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily