MEDICARE: DIVINE MERCY HOLISTIC CARE

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	:	1497606701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE MERCY HOLISTIC CARE

Provider Business Mailing Address
First Line	:	10 SUNRISE CT
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-3629
Country	:	US
Telephone Number	:	442-765-5409
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 SUNRISE CT
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-3629
Country	:	US
Telephone Number	:	442-765-5409
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICIA NKEM ONYEMEZIEM
Credential	:
Telephone Number	:	442-765-5409

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “DIVINE MERCY HOLISTIC CARE ” Practice Location

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