Healthcare Provider Details

I. General information

NPI: 1174447288
Provider Name (Legal Business Name): BLOOMHART HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 NIAGARA RD STE 122
COLLEGE PARK MD
20740-1110
US

IV. Provider business mailing address

4920 NIAGARA RD STE 122
COLLEGE PARK MD
20740-1110
US

V. Phone/Fax

Practice location:
  • Phone: 443-774-9753
  • Fax: 443-774-9753
Mailing address:
  • Phone: 443-774-9753
  • Fax: 443-774-9753

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: CHRISTAINA WABEKE
Title or Position: OWNER AND MANAGING MEMBER
Credential: DNP, PMHNP-BC
Phone: 443-774-9753