MEDICARE: A PEACEFUL MIND 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1316726631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PEACEFUL MIND LLC

Provider Business Mailing Address
First Line	:	6301 IVY LN STE 700
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-6330
Country	:	US
Telephone Number	:	301-349-6800
Fax Number	:	240-319-4101

Provider Business Practice Location Address
First Line	:	6301 IVY LN STE 700
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-6330
Country	:	US
Telephone Number	:	301-349-6800
Fax Number	:	240-319-4101

Authorized Official
Title or Position	:	OWNER
Name	:	MARGARETH J WEAVER
Credential	:
Telephone Number	:	301-349-6800

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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