Organization
COMPREHENSIVE HEALTHCARE & WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANESE SANDY CRNP (PROVIDER)
(240) 508-3363
Entity
Organization
Contact information
Practice address
1014 ANDEAN GOOSE WAY, UPPER MARLBORO, MD 20774-7128
(240) 508-3363
Mailing address
1014 ANDEAN GOOSE WAY, UPPER MARLBORO, MD 20774-7128
(240) 508-3363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
MD
Enumeration date
09/20/2021
Last updated
03/18/2022
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