Individual
EDEN D SHUMBULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5465 N MORGAN ST APT 501, ALEXANDRIA, VA 22312-3328
(703) 283-3923
Mailing address
5465 N MORGAN ST APT 501, ALEXANDRIA, VA 22312-3328
(703) 283-3923
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021084066
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021084066
ANCC
—
Enumeration date
10/11/2021
Last updated
10/11/2021
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