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General NPI Number Information
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NPI Number | 1255943502
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Entity Type | Organization
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Legal Business Name | NURSE PRACTITIONER SUPPORT
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 1 SAINT MARYS AVE # 101
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City | LA PLATA
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State | MD
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Zip | 20646-4037
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Country | US
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Telephone | 240-257-5436
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SAINT MARYS AVE STE 101
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City | LA PLATA
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State | MD
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Zip | 20646-4037
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Country | US
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Telephone | 240-257-5436
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Fax | 301-327-5432
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Authorized Official
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Title or Position | CO-OWNER, NURSE PRACTITIONER
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Name | DR. LAURA BEHM
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Credential | DNP, FNP-C
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Telephone | 240-257-5436
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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