Organization
ALLEGANY COLLEGE OF MARYLAND
Active
Other names
Nurse Managed Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNA KEPHART (OFFICE MANAGER)
(301) 784-5670
Entity
Organization
Contact information
Practice address
12401 WILLOWBROOK RD, CUMBERLAND, MD 21502-2559
(301) 784-5670
(301) 784-5093
Mailing address
12401 WILLOWBROOK RD, CUMBERLAND, MD 21502-2559
(301) 784-5670
(301) 784-5093
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
21D2093034
MD
363LF0000X
Family Nurse Practitioner
Primary
R081546
MD
363LF0000X
Family Nurse Practitioner
R095433
MD
Other
Enumeration date
08/25/2016
Last updated
04/28/2017
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