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General NPI Number Information
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NPI Number | 1720934938
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Entity Type | Organization
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Legal Business Name | VYBRANT HEALTH AND WELLNESS
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 6210 GEORGETOWN BLVD STE D
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City | ELDERSBURG
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State | MD
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Zip | 21784-6418
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Country | US
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Telephone | 410-702-4998
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Fax | 410-680-3444
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Provider Business Mailing Address
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Address Line | 6210 GEORGETOWN BLVD STE D
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City | ELDERSBURG
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State | MD
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Zip | 21784-6418
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Country | US
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Telephone | 410-702-4998
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Fax | 410-680-3444
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Authorized Official
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Title or Position | OWNER
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Name | ALFRED T TETTEH
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Credential |
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Telephone | 410-702-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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