# ELITE WEIGHTLOSS & TRT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JE Primary and Mental Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568283547
- **Authorized official:** MRS. EMILIENNE NKEMAYIM CRNP (OWNER)
- **Authorized official phone:** (410) 498-7055

## Contact information

- **Practice address:** 1604 RIDGESIDE DR STE B2, MOUNT AIRY, MD 21771-5240
- **Practice address phone:** (410) 498-7055
- **Mailing address:** 1604 RIDGESIDE DR STE B2, MOUNT AIRY, MD 21771-5240
- **Mailing address phone:** (410) 498-7055
- **Mailing address fax:** (410) 862-4191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/22/2024
- **Last updated:** 07/17/2025