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General NPI Number Information
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NPI Number | 1508760679
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Entity Type | Organization
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Legal Business Name | HEALIQUE HEALTH LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 2910 COLD SPRING WAY APT 334
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City | CROFTON
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State | MD
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Zip | 21114-2864
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Country | US
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Telephone | 301-747-1218
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Fax |
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Provider Business Mailing Address
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Address Line | 2910 COLD SPRING WAY APT 334
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City | CROFTON
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State | MD
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Zip | 21114-2864
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Country | US
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Telephone | 301-747-1218
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA GANT
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Credential | CRNP
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Telephone | 813-731-9771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NULL
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