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General NPI Number Information
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NPI Number | 1730997065
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Entity Type | Organization
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Legal Business Name | PRIME HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 6200 BALTIMORE AVE STE 300-24
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City | RIVERDALE PARK
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State | MD
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Zip | 20737-1054
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Country | US
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Telephone | 240-436-0550
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Fax | 301-962-2884
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Provider Business Mailing Address
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Address Line | 6200 BALTIMORE AVE STE 300-24
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City | RIVERDALE
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State | MD
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Zip | 20737-1054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARINE NDEKO
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Credential | NP
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Telephone | 240-436-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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