MANIFEST WELLNESS SERVICES LLC NPI 1851150833

NPI Information

  • NPI: 1851150833
  • Provider Name: MANIFEST WELLNESS SERVICES LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 6340 SECURITY BLVD STE B16
    WOODLAWN, MD
    ZIP 21207
  • Phone: (443) 531-4264

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NPI Details

MANIFEST WELLNESS SERVICES LLC is a family nurse practitioner in Woodlawn, MD. MANIFEST WELLNESS SERVICES LLC NPI is 1851150833. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6340 SECURITY BLVD STE B16
WOODLAWN, MD
ZIP 21207-173
Phone: (443) 531-4264

The provider's authorized official is Genevieve Ifeanyichukwu .
The authorized official title is Chief Executive Officer and has the following contact phone number (443) 531-4264.

The enumeration date for this NPI number is 3/13/2024 and was last updated on 3/13/2024.

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: 11/21/2025

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