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General NPI Number Information
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NPI Number | 1356805154
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Entity Type | Organization
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Legal Business Name | HEALTH EXPRESS OF MARYLAND INC
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 05/27/2019
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Provider Practice Location Address
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Address Line | 3669 OFFUTT RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-3515
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Country | US
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Telephone | 443-797-7582
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Fax |
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Provider Business Mailing Address
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Address Line | 3669 OFFUTT RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-3515
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Country | US
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Telephone | 443-797-7582
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Fax | 410-701-7182
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Authorized Official
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Title or Position | CEO
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Name | RACHEL OCHONIA ADEJOH
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Credential | CRNP
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Telephone | 443-797-7582
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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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