Healthcare Provider Details

I. General information

NPI: 1891584298
Provider Name (Legal Business Name): LYFEWORK HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8329 ARBOR STATION WAY
PARKVILLE MD
21234-4919
US

IV. Provider business mailing address

PO BOX 8450
PARKVILLE MD
21234-0450
US

V. Phone/Fax

Practice location:
  • Phone: 443-281-3689
  • Fax:
Mailing address:
  • Phone: 443-804-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MISS TANGELA LACHELLE ROBINSON
Title or Position: CARE MANAGER/HEALTH COACH
Credential: RN
Phone: 443-281-3689