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Organization
OPTIMUM FAMILY CLINIC
Active
Organization
OPTIMUM FAMILY CLINIC
Active
Other names
Optimum Family Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BLESSING GABRIEL CRNP (PROVIDER)
(703) 436-1823
Entity
Organization
Contact information
Practice address
6014 HARFORD RD, BALTIMORE, MD 21214-1327
(443) 985-6011
(866) 596-1084
Mailing address
6014 HARFORD RD, BALTIMORE, MD 21214-1327
(443) 985-6011
(866) 596-1084
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R198392
MARYLAND LICENSE
MD
Enumeration date
09/27/2018
Last updated
09/26/2019
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