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General NPI Number Information
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NPI Number | 1346987690
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Entity Type | Organization
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Legal Business Name | ELITE MEDICAL CARE LLC
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 9202 GLENARDEN PKWY
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City | GLENARDEN
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State | MD
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Zip | 20706-2666
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Country | US
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Telephone | 301-799-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 9202 GLENARDEN PKWY
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City | GLENARDEN
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State | MD
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Zip | 20706-2666
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Country | US
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Telephone | 301-799-7546
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | JAMESTINA DIOP
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Credential | CRNP-BC
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Telephone | 301-799-7546
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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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