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General NPI Number Information
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NPI Number | 1538867668
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Entity Type | Organization
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Legal Business Name | THE NERVE, LLC
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 3821 TIMBER VIEW WAY
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1839
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Country | US
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Telephone | 443-900-6897
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Fax |
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Provider Business Mailing Address
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Address Line | 3821 TIMBER VIEW WAY
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1839
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Country | US
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Telephone | 443-900-6897
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. TINA BRACY
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Credential | CRNP
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Telephone | 443-900-6897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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