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Organization
CERVELLO-WELLNESS, LLC
Active
Organization
CERVELLO-WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIMI TYSON (PSYCHIATRIC NURSE PRACTITIONER)
(301) 392-7120
Entity
Organization
Contact information
Practice address
6010 EXECUTIVE BLVD STE 700, NORTH BETHESDA, MD 20852-3885
(301) 392-7120
Mailing address
4014 DIAMONDHEAD AVE, BOWIE, MD 20721-1308
(301) 828-5239
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
05/30/2026
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