Healthcare Provider Details

I. General information

NPI: 1740853753
Provider Name (Legal Business Name): HEALER HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7004 SECURITY BLVD STE 300-A5
BALTIMORE MD
21244-2557
US

IV. Provider business mailing address

7004 SECURITY BLVD STE 300-A5
BALTIMORE MD
21244-2557
US

V. Phone/Fax

Practice location:
  • Phone: 410-978-6577
  • Fax:
Mailing address:
  • Phone: 410-978-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TOLULOPE LAWSON-JOHN
Title or Position: CEO
Credential:
Phone: 410-978-6577