| Neighborhood Nurse | |
|
3421 Gentle Breeze Dr Ste A Upper Marlboro MD 20772-2549 | |
| (443) 529-2027 | |
| (240) 306-9503 |
| Full Name | Neighborhood Nurse |
|---|---|
| Speciality | Clinic/Center |
| Location | 3421 Gentle Breeze Dr Ste A, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Timika Shante Fisher (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4435292027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Nurse 3421 Gentle Breeze Dr Upper Marlboro MD 20772-2549 Ph: (144) 352-9202 | Neighborhood Nurse 3421 Gentle Breeze Dr Ste A Upper Marlboro MD 20772-2549 Ph: (443) 529-2027 |
| NPI Number | 1609594704 |
|---|---|
| Provider Enumeration Date | 08/16/2022 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/12/2025 |
| Medicare PECOS PAC ID | 2567837867 |
|---|---|
| Medicare Enrollment ID | O20230418001467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609594704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Timika Goodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053910794 PECOS PAC ID: 9335553064 Enrollment ID: I20230418001697 |
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