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NPI Code Detail

MEDICARE: ELEVATE HEALTH LLC

MEDICARE: ELEVATE 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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1215754643
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEVATE HEALTH LLC
Provider Business Mailing Address
First Line : 10923 LOUIS DETRICK LN
Second Line :
City : MONROVIA
State : MD
Zip : 21770-6024
Country : US
Telephone Number : 707-637-6859
Fax Number :
Provider Business Practice Location Address
First Line : 176 THOMAS JOHNSON DR STE 203
Second Line :
City : FREDERICK
State : MD
Zip : 21702-4535
Country : US
Telephone Number : 240-831-1921
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LINDA OGBODO
Credential :
Telephone Number : 707-637-6859
Provider Enumeration Date : 09/25/2024
Last Update Date : 01/15/2026

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Directions to “ELEVATE HEALTH LLC ” Practice Location

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