Healthcare Provider Details

I. General information

NPI: 1952241028
Provider Name (Legal Business Name): ELEVATE HEALTH & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N FULTON AVE
BALTIMORE MD
21217-1443
US

IV. Provider business mailing address

1020 N FULTON AVE
BALTIMORE MD
21217-1443
US

V. Phone/Fax

Practice location:
  • Phone: 305-600-9706
  • Fax:
Mailing address:
  • Phone: 305-600-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAJAIRA POWELL-BAILEY
Title or Position: CEO
Credential: FNP-BC
Phone: 305-600-9706