Active NPI
Nnenna Ezeocha
- Pharmacist
- Glen Burnie, MD
National Provider Identifier
1639328891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18698
- Practice address
- 1712 Crain Hwy S
Glen Burnie, MD 21061-5503 - Phone
- (410) 761-1099
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18698 | MD | Primary |
Addresses
Primary practice location
1712 Crain Hwy S
Glen Burnie, MD 21061-5503
Mailing address
44 Badger Gate CT
Catonsville, MD 21228-3662
Phone (410) 737-4623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18698 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KJT Support Solutions | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- Ellicott City, MD
- NPI 1124821004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1639328891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 BADGER GATE CT",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212283662",
"telephone_number": "410-737-4623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 CRAIN HWY S",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210615503",
"telephone_number": "410-761-1099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEOCHA",
"first_name": "NNENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "18698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.