Organization
CANNAKUSH CONSULTING OFFICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY MOORE CRNP (OWNER)
(443) 750-0222
Entity
Organization
Contact information
Practice address
5411 OLD FREDERICK RD STE 18, BALTIMORE, MD 21229-2126
(443) 750-0222
Mailing address
5411 OLD FREDERICK RD STE 18, BALTIMORE, MD 21229-2126
(443) 750-0222
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/01/2021
Last updated
06/05/2024
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