=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831940717
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURE MEDSPA AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2024
-----------------------------------------------------
Last Update Date | 03/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8508 LOCH RAVEN BLVD STE A
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21286-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-853-7824
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4820 NORWOOD AVE STE A
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21207-6839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-622-9248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | COURTNEY MICHELLE ROBERTS-JONES
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 443-622-9248
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------