Healthcare Provider Details

I. General information

NPI: 1922894260
Provider Name (Legal Business Name): DELMARVA MOBILE WOUND SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7970 KINNIKIN CT
HEBRON MD
21830-2212
US

IV. Provider business mailing address

7970 KINNIKIN CT
HEBRON MD
21830-2212
US

V. Phone/Fax

Practice location:
  • Phone: 410-603-6767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BETH SANABRIA
Title or Position: OWNER
Credential:
Phone: 410-603-6767