Healthcare Provider Details

I. General information

NPI: 1689904005
Provider Name (Legal Business Name): NATURAL FAMILY WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 GALLANT FOX LN SUITE 205
BOWIE MD
20715-4003
US

IV. Provider business mailing address

14300 GALLANT FOX LN SUITE 205
BOWIE MD
20715-4003
US

V. Phone/Fax

Practice location:
  • Phone: 301-805-8031
  • Fax: 301-805-7043
Mailing address:
  • Phone: 301-805-8031
  • Fax: 301-805-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD44864
License Number StateMD

VIII. Authorized Official

Name: DR. VANESSA MARIA ALLEN
Title or Position: OWNER
Credential: M.D.
Phone: 301-805-8031