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General NPI Number Information
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NPI Number | 1053937573
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Entity Type | Organization
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Legal Business Name | GREATER CHESAPEAKE HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 06/20/2020
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Last Update Date | 06/20/2020
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Provider Practice Location Address
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Address Line | 1900 E NORTHERN PKWY STE T6
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City | BALTIMORE
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State | MD
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Zip | 21239-2120
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Country | US
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Telephone | 443-438-6893
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Fax | 443-869-4437
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Provider Business Mailing Address
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Address Line | 1900 E NORTHERN PKWY STE T6
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City | BALTIMORE
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State | MD
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Zip | 21239-2120
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Country | US
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Telephone | 443-438-6893
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Fax | 443-869-4437
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | HARA OYEDEJI
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Credential | CRNP
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Telephone | 732-768-0386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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