Organization
DIVINE HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIMBOLA HILLARD FNP-BC (PRESIDENT)
(240) 501-8616
Entity
Organization
Contact information
Practice address
1778 GRANDE VIEW AVE, SEVERN, MD 21144-3333
(410) 551-5849
(410) 551-0685
Mailing address
1778 GRANDE VIEW AVE, SEVERN, MD 21144-3333
(410) 551-5849
(410) 551-0685
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
11/05/2021
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