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General NPI Number Information
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NPI Number | 1366840589
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Entity Type | Organization
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Legal Business Name | YOUR HEALTH NETWORK, INC.
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 733 W 40TH ST SUITE 200
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City | BALTIMORE
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State | MD
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Zip | 21211-2112
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Country | US
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Telephone | 443-451-4993
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 FALLS ROAD SUITE 1
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City | BALTIMORE
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State | MD
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Zip | 21211-2112
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Country | US
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Telephone | 443-963-2818
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JESSICA KOHNEN
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Credential |
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Telephone | 443-451-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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