Healthcare Provider Details

I. General information

NPI: 1386361731
Provider Name (Legal Business Name): MIND BODY NP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

5120 BRITTEN LN
ELLICOTT CITY MD
21043-7081
US

V. Phone/Fax

Practice location:
  • Phone: 410-844-6401
  • Fax: 844-820-7074
Mailing address:
  • Phone: 410-844-6401
  • Fax: 844-820-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH JENKINS
Title or Position: OWNER
Credential: NP
Phone: 410-844-6401