Organization
OPTIMUM FAMILY CLINIC
Active
Other names
Optimum Family Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BLESSING GABRIEL CRNP (PROVIDER)
(703) 436-1823
Entity
Organization
Contact information
Practice address
6014 HARFORD RD, BALTIMORE, MD 21214-1327
(443) 985-6011
(866) 596-1084
Mailing address
6014 HARFORD RD, BALTIMORE, MD 21214-1327
(443) 985-6011
(866) 596-1084
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R198392
MARYLAND LICENSE
MD
Enumeration date
09/27/2018
Last updated
09/26/2019
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