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General NPI Number Information
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NPI Number | 1336764729
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Entity Type | Organization
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Legal Business Name | ENVISION HEALTH AND WELLNESS
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 9712 BELAIR RD STE 301
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City | BALTIMORE
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State | MD
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Zip | 21236-1113
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Country | US
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Telephone | 443-883-1826
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Fax |
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Provider Business Mailing Address
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Address Line | 8840 BELAIR RD
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City | BALTIMORE
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State | MD
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Zip | 21236-2401
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Country | US
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Telephone | 443-883-1826
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Fax |
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | MRS. CHRISTIE SIMON-WATERMAN
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Credential | DNP, CRNP
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Telephone | 443-867-7471
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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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