Healthcare Provider Details

I. General information

NPI: 1598920365
Provider Name (Legal Business Name): NMSHEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4922 LASALLE RD
HYATTSVILLE MD
20782-3302
US

IV. Provider business mailing address

4922 LASALLE RD
HYATTSVILLE MD
20782-3302
US

V. Phone/Fax

Practice location:
  • Phone: 301-910-7967
  • Fax: 301-864-1095
Mailing address:
  • Phone: 301-910-7967
  • Fax: 301-864-1095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberR129919
License Number StateMD

VIII. Authorized Official

Name: MS. DARLENE M BROWNLEE
Title or Position: DIRECTOR OF NURSE PRACTITIONER
Credential: CRNP
Phone: 301-910-7967