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General NPI Number Information
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NPI Number | 1104346006
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Entity Type | Individual
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Provider Name | CHARITY ALLWELL
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 8101 SANDY SPRING RD STE 110
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City | LAUREL
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State | MD
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Zip | 20707-3596
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Country | US
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Telephone | 301-455-4116
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Fax | 240-554-2345
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Provider Business Mailing Address
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Address Line | 7365 CEDAR AVE
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City | JESSUP
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State | MD
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Zip | 20794-9456
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Country | US
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Telephone | 301-455-4116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | R183253
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R183253
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R183253
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License Number State | MD
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