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Organization

PRIMARY ADDICTIONS SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KELLY MARIE BLOSSER CRNP (NURSE PRACTITIONER / OWNER)
(410) 591-5161
Entity
Organization

Contact information

Practice address
260 GATEWAY DR STE 6A, BEL AIR, MD 21014-4266
(443) 987-6481
Mailing address
1117 KNOPP RD, JARRETTSVILLE, MD 21084-1614

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R134812
MD

Other

Enumeration date
10/03/2017
Last updated
10/03/2017
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