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ESSENTIAL CARE CLINIC LLC NPI 1568157212


NPI Information

NPI: 1568157212
Provider Name: ESSENTIAL CARE CLINIC LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 21D2291562

Address:
6507 OLD BRANCH AVE STE 101
TEMPLE HILLS, MD
ZIP 20748
Phone: (240) 247-0791
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ESSENTIAL CARE CLINIC LLC is a family nurse practitioner in Temple Hills, MD. ESSENTIAL CARE CLINIC LLC NPI is 1568157212. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6507 OLD BRANCH AVE STE 101
TEMPLE HILLS, MD
ZIP 20748-628
Phone: (240) 247-0791

The provider's authorized official is Jacquelyn Bailey .
The authorized official title is Provider and has the following contact phone number (240) 247-0791.

The CLIA number assigned to this NPI record is 21D2291562 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/10/2023 and was last updated on 4/10/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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