| NPI | 1285510685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNTELLE ELLIS Nurse Practitioner 301-467-5033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-08-12 |