Organization
DIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CHIKEZIE (OWNER)
(240) 476-9409
Entity
Organization
Contact information
Practice address
9420 ANNAPOLIS RD STE 103, LANHAM, MD 20706-3033
(240) 476-9409
(240) 436-0043
Mailing address
12912 CROSSFIELD DR, BELTSVILLE, MD 20705-6334
(240) 476-9409
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/16/2023
Last updated
06/09/2026
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