NPI | 1821700014 |
---|---|
Former Legal Business Name | AZURA WELLNESS |
Entity Type | Organization |
Authorized Contact | LISA JOHNSON Owner & CEO 301-985-2898 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 163W00000X Registered Nurse |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-12-19 |
Last Update Date | 2023-01-17 |