Organization
PRIMARY ELITE HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESSA WILLIAMS CRNP (NP)
(443) 744-6214
Entity
Organization
Contact information
Practice address
9627 EAVES DRIVE, OWINGS MILLS, MD 21117
(443) 744-6214
Mailing address
9627 EAVES DR, OWINGS MILLS, MD 21117-5919
(443) 744-6214
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689148256
—
MD
05
—
1922514348
—
MD
Enumeration date
02/26/2021
Last updated
02/26/2021
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