Organization
MERCY URGENT CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRUDENCE A MANCHO FNP-BC (OWNER)
(301) 807-6957
Entity
Organization
Contact information
Practice address
2257 BEL PRE RD, SILVER SPRING, MD 20906-2204
(301) 807-6957
Mailing address
2257 BEL PRE RD, SILVER SPRING, MD 20906-2204
(301) 460-8000
(301) 200-4610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R149483
MD
363LF0000X
Family Nurse Practitioner
Primary
2011002215
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336538700
—
MD
Enumeration date
09/14/2012
Last updated
05/16/2013
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