=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437752409
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FEEL BETTER HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2020
-----------------------------------------------------
Last Update Date | 08/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9105 ALL SAINTS RD STE M
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20723-1750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-571-6690
-----------------------------------------------------
Fax | 888-498-3144
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5021 ROME RED WAY
-----------------------------------------------------
City | ELLICOTT CITY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21043-6847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-571-6690
-----------------------------------------------------
Fax | 888-498-3144
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CRNP/NURSE PRACTITIONER
-----------------------------------------------------
Name | HARSANA SHOWUNMI
-----------------------------------------------------
Credential | DNP, CRNP, BSN
-----------------------------------------------------
Telephone | 443-631-7258
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------