Healthcare Provider Details

I. General information

NPI: 1467009423
Provider Name (Legal Business Name): HEALTHWELL, NP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 CHERRY HILL RD STE 101
BROOKLYN MD
21225-1228
US

IV. Provider business mailing address

631 CHERRY HILL RD STE 101
BROOKLYN MD
21225-1228
US

V. Phone/Fax

Practice location:
  • Phone: 443-898-6622
  • Fax:
Mailing address:
  • Phone: 443-898-6622
  • 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: TRIDONNA DEVAL BRANDFORD
Title or Position: OWNER
Credential: CRNP
Phone: 443-898-6622