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General NPI Number Information
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NPI Number | 1265102545
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Entity Type | Organization
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Legal Business Name | FNP CONCIERGE HOME MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 2339 MAYTIME DR
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City | GAMBRILLS
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State | MD
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Zip | 21054-1434
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Country | US
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Telephone | 410-271-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 2339 MAYTIME DR
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City | GAMBRILLS
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State | MD
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Zip | 21054-1434
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Country | US
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Telephone | 410-271-0335
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MS. REBECCA JEAN MYSIUK
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Credential | CRNP
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Telephone | 410-271-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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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 | 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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