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General NPI Number Information
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NPI Number | 1104677913
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Entity Type | Organization
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Legal Business Name | VITAL CURE PRIMARY SERVICES LLC
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Dates
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Enumeration Date | 03/29/2024
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Last Update Date | 10/25/2025
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Provider Practice Location Address
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Address Line | 8508 LOCH RAVEN BLVD STE A
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City | BALTIMORE
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State | MD
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Zip | 21286-2354
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Country | US
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Telephone | 443-377-5743
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Fax |
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Provider Business Mailing Address
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Address Line | 4820 NORWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21207-6839
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Country | US
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Telephone | 443-622-9248
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Fax |
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Authorized Official
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Title or Position | OWNER/ APRN
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Name | COURTNEY MICHELLE ROBERTS
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Credential | APRN
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Telephone | 443-622-9248
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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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