Provider Demographics
NPI:1487412904
Name:ESEN, UKACHI DANIEL (NP)
Entity type:Individual
Prefix:
First Name:UKACHI
Middle Name:DANIEL
Last Name:ESEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 WASHINGTON BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4615
Mailing Address - Country:US
Mailing Address - Phone:240-050-9350
Mailing Address - Fax:
Practice Address - Street 1:229 WASHINGTON BLVD S
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4615
Practice Address - Country:US
Practice Address - Phone:240-050-9350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215967363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health