Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stanislaus Mbong Ebako, RN

Individual provider Registered Nurse · NPI 1063715787

Stanislaus Mbong Ebako, RN is an Undefined Non-Physician Type (Specify) in Alexandria, Virginia. Qualified in 2007, 19 years ago. Practices as a sole proprietor. Licensed in Virginia.

Years since qualifying
19
Licensed in
VA
In the registry since
2010
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone: (703) 746-3400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 0001214658 (VA)

Record details

NPI number1063715787
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedDecember 20, 2010
Last updated in NPPESJune 13, 2024
Certification dateJune 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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