Healthcare Provider Details

I. General information

NPI: 1003739004
Provider Name (Legal Business Name): NOVARE HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 4332
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 4332
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 240-822-9130
  • Fax:
Mailing address:
  • Phone: 240-822-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OLUCHI VICTORY UKAH
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 240-822-9130