Healthcare Provider Details

I. General information

NPI: 1043778160
Provider Name (Legal Business Name): A PLATFORM TO HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 YORK RD
BALTIMORE MD
21212-4225
US

IV. Provider business mailing address

325 AHERN DR
EDGEWOOD MD
21040-3410
US

V. Phone/Fax

Practice location:
  • Phone: 410-417-5297
  • Fax: 410-510-1375
Mailing address:
  • Phone: 410-417-5297
  • Fax: 410-510-1375

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: MRS. JOSIE DANTZLER
Title or Position: OWNER/ OPERATOR
Credential: PMHNP-BC
Phone: 410-417-5297