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General NPI Number Information
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NPI Number | 1033719307
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Entity Type | Organization
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Legal Business Name | TRUTH REPRODUCTIVE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 300 REXBURG AVE
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6103
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Country | US
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Telephone | 502-553-9710
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Fax |
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Provider Business Mailing Address
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Address Line | 300 REXBURG AVE
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6103
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Country | US
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Telephone | 502-553-9710
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VONTRESE L WARREN
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Credential | APRN, WHNP-BC
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Telephone | 502-553-9710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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