Organization
FAMILYCARE NURSE PRACTITIONER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGWANMA NWOKORO CRNP (CEO)
(410) 945-2289
Entity
Organization
Contact information
Practice address
2300 GARRISON BLVD STE 100, BALTIMORE, MD 21216-2308
(410) 945-2289
(410) 945-4255
Mailing address
2300 GARRISON BLVD STE 100, BALTIMORE, MD 21216-2308
(410) 945-2289
(410) 945-4255
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
772050500
—
MD
Enumeration date
01/19/2020
Last updated
01/19/2020
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