MEDICARE: ADVITA HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1194674200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVITA HEALTH LLC

Provider Business Mailing Address
First Line	:	979 COACHWAY
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-6413
Country	:	US
Telephone Number	:	443-618-3459
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 BRIGHTSEAT RD
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-3738
Country	:	US
Telephone Number	:	240-487-4400
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	KAREN PIPKIN
Credential	:
Telephone Number	:	443-618-3459

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “ADVITA HEALTH LLC ” Practice Location

Language	Start Address	Practice Location

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