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Individual

EXODUS NZERUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
REGISTERED NURSE

Contact information

Practice address
801 LAKE SHORE DR, BOWIE, MD 20721-2909
(240) 486-0744
Mailing address
801 LAKE SHORE DR, BOWIE, MD 20721-2909

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1028565
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1028565
DC
Enumeration date
04/21/2020
Last updated
04/21/2020
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