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Organization

MOONGLADE INTEGRATIVE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER LYNN RESH CRNP (EMPLOYEE)
(240) 321-2770
Entity
Organization

Contact information

Practice address
3233B CHESTNUT RIDGE RD, GRANTSVILLE, MD 21536-1370
(240) 321-2770
Mailing address
300 STIFF RD, ADDISON, PA 15411-2057
(240) 321-2770

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
08/15/2023
Last updated
02/12/2024
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