Organization
PERIDOT PRIMARY CARE, LLC
Active
Other names
True Vitality Consulting, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PRINCESS STEPHENSON (MANAGING MEMBER)
(301) 298-9919
Entity
Organization
Contact information
Practice address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
(301) 215-2309
(855) 942-3275
Mailing address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
(301) 298-9919
(301) 298-9917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
01/11/2022
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