| NPI | 1255180113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON M. CROMWELL Administrator 443-617-0966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |