MEDICARE: HEALTHWISE

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	R134703	MD

General Provider Information

NPI Number	:	1780041012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWISE

Provider Business Mailing Address
First Line	:	PO BOX 19951
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-0951
Country	:	US
Telephone Number	:	410-235-3854
Fax Number	:	410-235-3854

Provider Business Practice Location Address
First Line	:	2620 N CALVERT ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-4616
Country	:	US
Telephone Number	:	410-235-3854
Fax Number	:	410-235-3854

Authorized Official
Title or Position	:	OWNER / SOLE PROPRIETOR
Name	:	MS. MARY-RITA ELIZABETH BLUTE
Credential	:	CRNP
Telephone Number	:	410-235-3854

Provider Enumeration Date	:	01/18/2016
Last Update Date	:	01/18/2016

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Directions to “HEALTHWISE ” Practice Location

Language	Start Address	Practice Location

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