Healthcare Provider Details

I. General information

NPI: 1427978378
Provider Name (Legal Business Name): BLENDIN IT UP NUTRITION AND FITNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 WINTERSON RD SUITE 200
LINTHICUM HEIGHTS MD
21090-2245
US

IV. Provider business mailing address

1190 WINTERSON RD SUITE 200
LINTHICUM HEIGHTS MD
21090-2245
US

V. Phone/Fax

Practice location:
  • Phone: 877-571-7222
  • Fax:
Mailing address:
  • Phone: 877-571-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KEVA BALLARD
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 240-462-9321