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General NPI Number Information
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NPI Number | 1316662190
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Entity Type | Organization
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Legal Business Name | SEETAK HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 937 RUSSELL AVE STE A
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City | GAITHERSBURG
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State | MD
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Zip | 20879-3280
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Country | US
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Telephone | 240-477-4047
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Fax | 240-690-4128
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Provider Business Mailing Address
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Address Line | 937 RUSSELL AVE STE A
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City | GAITHERSBURG
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State | MD
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Zip | 20879-3280
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Country | US
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Telephone | 240-477-4047
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Fax | 240-690-4128
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. FLORENCE O FAKAYODE
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Credential | CRNP
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Telephone | 240-277-3873
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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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