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General NPI Number Information
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NPI Number | 1053066936
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Entity Type | Organization
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Legal Business Name | PINNACLE FAMILY CARE PRACTICE
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 11/06/2022
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Provider Practice Location Address
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Address Line | 5835 YORK RD
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City | BALTIMORE
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State | MD
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Zip | 21212-3612
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Country | US
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Telephone | 443-912-5077
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Fax | 410-835-7865
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Provider Business Mailing Address
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Address Line | 10220 S DOLFIELD RD STE 105
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3660
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Country | US
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Telephone | 443-912-5077
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Fax | 410-835-7865
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MS. ADENIKE A. POPOOLA
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Credential | CRNP
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Telephone | 443-527-1497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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