| NPI | 1538989991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA ALICE JOHNSTON CEO 240-353-2516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-11 |