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General NPI Number Information
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NPI Number | 1922914050
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Entity Type | Organization
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Legal Business Name | CONTINUUM WOUND AND PRIMARY CARE LLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 12513 WOODSONG LN
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City | BOWIE
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State | MD
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Zip | 20721-4225
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Country | US
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Telephone | 256-417-7067
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Fax |
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Provider Business Mailing Address
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Address Line | 12513 WOODSONG LN
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City | BOWIE
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State | MD
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Zip | 20721-4225
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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 | BONAVENTURE MBELLA
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Credential |
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Telephone | 256-417-7067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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