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General NPI Number Information
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NPI Number | 1548612799
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Entity Type | Organization
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Legal Business Name | MOBILE NP LLC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 3927 MCDONOGH RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-3633
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Country | US
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Telephone | 410-963-5535
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Fax | 410-655-2969
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Provider Business Mailing Address
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Address Line | 3927 MCDONOGH RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-3633
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Country | US
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Telephone | 410-963-5535
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Fax | 410-655-2969
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. VERONICA ANNETTE HOLLAND-BARNER
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Credential | C.R.N.P
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Telephone | 410-963-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | R158140
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License Number State | MD
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