Healthcare Provider Details
I. General information
NPI: 1750033643
Provider Name (Legal Business Name): SCONZA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2022
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
218 E LEXINGTON ST STE 200
BALTIMORE MD
21202-3520
US
IV. Provider business mailing address
1821 MORNING BROOK DR
FOREST HILL MD
21050-2629
US
V. Phone/Fax
- Phone: 410-275-0975
- Fax: 410-275-0983
- Phone: 410-275-0975
- Fax: 410-275-0983
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANCISCA
C
NWAIGWE
Title or Position: CO-OWNER
Credential: MSN, FNP-BC
Phone: 410-866-0000