Organization
ELITE WEIGHTLOSS & TRT
Active
Other names
JE Primary and Mental Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILIENNE NKEMAYIM CRNP (OWNER)
(410) 498-7055
Entity
Organization
Contact information
Practice address
1604 RIDGESIDE DR STE B2, MOUNT AIRY, MD 21771-5240
(410) 498-7055
Mailing address
1604 RIDGESIDE DR STE B2, MOUNT AIRY, MD 21771-5240
(410) 498-7055
(410) 862-4191
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/22/2024
Last updated
07/17/2025
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