Organization
COMMUNITY WELLNESS AND OCCUPATIONAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MINNIE NDEM CRNP (NURSE PRACTITIONER)
(410) 709-8471
Entity
Organization
Contact information
Practice address
9808 LIBERTY RD, RANDALLSTOWN, MD 21133-2007
(410) 709-8471
Mailing address
9808 LIBERTY RD, RANDALLSTOWN, MD 21133-2007
(410) 709-8471
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R132005
MD
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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