# OPTIMUM FAMILY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optimum Family Clinic LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336624113
- **Authorized official:** MISS BLESSING GABRIEL CRNP (PROVIDER)
- **Authorized official phone:** (703) 436-1823

## Contact information

- **Practice address:** 6014 HARFORD RD, BALTIMORE, MD 21214-1327
- **Practice address phone:** (443) 985-6011
- **Practice address fax:** (866) 596-1084
- **Mailing address:** 6014 HARFORD RD, BALTIMORE, MD 21214-1327
- **Mailing address phone:** (443) 985-6011
- **Mailing address fax:** (866) 596-1084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2018
- **Last updated:** 09/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | R198392 | MARYLAND LICENSE | MD |