Individual
CAROLINE IBIJEMILUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9470 ANNAPOLIS RD STE 402, LANHAM, MD 20706-3059
(240) 770-6689
(240) 667-2190
Mailing address
9470 ANNAPOLIS RD STE 402, LANHAM, MD 20706-3059
(240) 770-6689
(240) 667-2190
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R160696
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
R160656
MD
Other
Enumeration date
09/22/2018
Last updated
02/13/2025
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