Eyerusalem Daniel Abdeta, NURSE PRACTITIONER

Individual provider Active NPI Acute Care Nurse Practitioner · Greenbelt, MD

NPI 1386450583 · NPPES record last updated Dec 4, 2024

Key facts

NPI
1386450583
Entity type
Individual (NPI type 1)
Primary specialty
Acute Care Nurse Practitioner 363LA2100X
License
2024054913 (MD)
Practice address
8268 Miner St
Greenbelt, MD 20770
Phone
(612) 244-9329
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2024054913MDMDAcute Care Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2024054913 MD Yes

Addresses

Primary practice location

8268 Miner St
Greenbelt, MD 20770

Mailing address

8268 Miner St
Greenbelt, MD 20770
Phone (612) 244-9329

Other providers in Greenbelt, MD

All providers in Greenbelt, MD · Acute Care Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.