Individual
CONSOLATA EBEKONYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8600 LASALLE ROAD, TOWSON, MD 21286
(443) 985-0391
Mailing address
7922 GALLOPING CIR, BALTIMORE, MD 21244-1278
(410) 227-5483
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R142494
MD
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
R142494
MD
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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