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Organization
SEVA HEALTH, LLC
Active
Organization
SEVA HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGEL V SHANNON CRNP (EXECUTIVE DIRECTOR)
(410) 299-3803
Entity
Organization
Contact information
Practice address
9133 SUNSET RIDGE RD, RANDALLSTOWN, MD 21133-3651
(410) 299-3803
Mailing address
9133 SUNSET RIDGE RD, RANDALLSTOWN, MD 21133-3651
(410) 299-3803
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R121021
MD
363LG0600X
Gerontology Nurse Practitioner
R121021
MD
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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