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General NPI Number Information
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NPI Number | 1255113262
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Entity Type | Organization
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Legal Business Name | URBANA SPINE AND WELLNESS CENTER
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 8927 FINGERBOARD RD STE B
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City | FREDERICK
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State | MD
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Zip | 21704-8164
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Country | US
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Telephone | 240-656-5600
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Fax | 240-599-1502
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Provider Business Mailing Address
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Address Line | 8927 FINGERBOARD RD STE B
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City | FREDERICK
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State | MD
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Zip | 21704-8164
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Country | US
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Telephone | 240-656-5600
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Fax | 240-599-1502
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Authorized Official
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Title or Position | MEMBER
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Name | MELISSA R BOLDEN
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Credential | CRNP
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Telephone | 301-606-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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