# MODVIVA HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770426371
- **Authorized official:** PAWN JOHNSON-HUNTER AGPCNP (NURSE PRACTITIONER)
- **Authorized official phone:** (443) 687-1421

## Contact information

- **Practice address:** 6600 BELAIR RD STE 2B, BALTIMORE, MD 21206-1855
- **Practice address phone:** (443) 687-1421
- **Mailing address:** 6600 BELAIR RD STE 2B, BALTIMORE, MD 21206-1855
- **Mailing address phone:** (443) 687-1421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/10/2026
- **Last updated:** 04/10/2026