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General NPI Number Information
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NPI Number | 1790249084
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Entity Type | Organization
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Legal Business Name | TRUE PHOENIX COMMUNITY CARE, LLC
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2316 E JOPPA RD STE 1
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City | PARKVILLE
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State | MD
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Zip | 21234-2808
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Country | US
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Telephone | 443-793-7220
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Fax | 443-687-8705
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Provider Business Mailing Address
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Address Line | 2316 E JOPPA RD STE 1
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City | PARKVILLE
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State | MD
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Zip | 21234-2808
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Country | US
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Telephone | 443-793-7220
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Fax | 443-687-8705
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | JINAYA S. BEATTY
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Credential | DNP, CRNP, FNP-BC
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Telephone | 443-793-7220
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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 |
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License Number State |
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