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General NPI Number Information
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NPI Number | 1689459489
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Entity Type | Organization
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Legal Business Name | HEART OWN MEDICAL SERVICES
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 2527 GREENMOUNT AVE
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City | BALTIMORE
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State | MD
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Zip | 21218-4721
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Country | US
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Telephone | 443-827-3802
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Fax |
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Provider Business Mailing Address
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Address Line | 3905 EDNOR RD
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City | BALTIMORE
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State | MD
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Zip | 21218-2054
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Country | US
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Telephone | 443-827-3802
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | ASHLEY SYDNOR
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Credential | NP
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Telephone | 443-827-3802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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