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General NPI Number Information
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NPI Number | 1891534194
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Entity Type | Organization
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Legal Business Name | HOLISTIC CARE FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 1900 E NORTHERN PKWY STE 208
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City | BALTIMORE
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State | MD
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Zip | 21239-2110
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Country | US
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Telephone | 410-339-0590
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Fax | 410-339-0591
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Provider Business Mailing Address
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Address Line | 1900 E NORTHERN PKWY STE 208
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City | BALTIMORE
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State | MD
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Zip | 21239-2110
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Country | US
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Telephone | 410-339-0590
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MORENIKE AGBOOLA
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Credential |
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Telephone | 410-339-0590
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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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