Organization
MAGNOLIA HEALTH CARE LLC
Active
Other names
Magnolia Body Renew, Magnolia Mobile Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAQUILLA VAZQUEZ CLARK DNP, MSN, CRNP, FNP- (FAMILY NURSE PRACTITIONER)
(301) 715-3010
Entity
Organization
Contact information
Practice address
2407 BANEBERRY LN, GAMBRILLS, MD 21054-1992
(301) 715-3010
(410) 220-8162
Mailing address
2407 BANEBERRY LN, GAMBRILLS, MD 21054-1992
(301) 715-3010
(410) 220-8162
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/30/2024
Last updated
01/02/2026
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