Individual
JOHN EJIKEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
29398 RECOVERY WAY, JUNCTION CITY, OR 97448-8447
(541) 465-2554
Mailing address
537 4TH ST, SPRINGFIELD, OR 97477-4619
(214) 875-1806
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
939339
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10033753
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP6139409
WA
Other
Enumeration date
04/27/2019
Last updated
01/01/2025
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