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General NPI Number Information
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NPI Number | 1043086135
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Entity Type | Organization
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Legal Business Name | MY CARE WELLNESS LLC
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 4041 POWDER MILL RD STE 206
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City | BELTSVILLE
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State | MD
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Zip | 20705-3106
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Country | US
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Telephone | 301-806-0997
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 POWDER MILL RD STE 206
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City | BELTSVILLE
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State | MD
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Zip | 20705-3106
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Country | US
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Telephone | 301-806-0997
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MRS. NANAH HANNAH SEVALIE
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Credential | CRNP
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Telephone | 240-421-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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