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Organization

HEALTHSPAN COMPREHENSIVE HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETERSON NGUYEN PMHNP, CRNP (OWNER)
(410) 988-4418
Entity
Organization

Contact information

Practice address
5502 EDMONDSON AVE, BALTIMORE, MD 21229-2220
(410) 988-4418
Mailing address
4380B MONTGOMERY RD # 1051, ELLICOTT CITY, MD 21043-6006

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/19/2026
Last updated
01/26/2026
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