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General NPI Number Information
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NPI Number | 1245654649
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Entity Type | Organization
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Legal Business Name | ATLANTIS WELLNESS
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 9213 KENSINGTON PKWY
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6703
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Country | US
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Telephone | 301-525-2013
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Fax | 301-960-4830
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Provider Business Mailing Address
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Address Line | 9213 KENSINGTON PKWY
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6703
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Country | US
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Telephone | 301-525-2013
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Fax | 301-960-4830
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Authorized Official
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Title or Position | CRNP/OWNER
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Name | MS. KAREN ASPINWALL MILLETT
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Credential | CRNP
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Telephone | 301-525-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | R129024
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License Number State | MD
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