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General NPI Number Information
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NPI Number | 1811596281
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Entity Type | Organization
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Legal Business Name | WINNERS HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 6490 LANDOVER RD STE A
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City | CHEVERLY
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State | MD
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Zip | 20785-1443
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Country | US
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Telephone | 410-903-9206
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Fax |
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Provider Business Mailing Address
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Address Line | 1529 WINFIELDS LN
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City | GAMBRILLS
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State | MD
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Zip | 21054-1127
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Country | US
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Telephone | 410-790-9640
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. JUMOKE FADEKE OMISORE
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Credential | NP
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Telephone | 410-790-9640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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