| Holistic Health And Wellness Llc | |
|
1105 N Point Blvd Ste 321 Baltimore MD 21224-3472 | |
| (410) 517-7060 | |
| (443) 407-2942 |
| Full Name | Holistic Health And Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1105 N Point Blvd Ste 321, Baltimore, Maryland |
| Authorized Official Name and Position | Michelle Blackston (OWNER/DIRECTOR) |
| Authorized Official Contact | 4105177060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Health And Wellness Llc 1105 N Point Blvd Ste 321 Baltimore MD 21224-3472 Ph: (410) 517-7060 | Holistic Health And Wellness Llc 1105 N Point Blvd Ste 321 Baltimore MD 21224-3472 Ph: (410) 517-7060 |
| NPI Number | 1396355129 |
|---|---|
| Provider Enumeration Date | 08/06/2020 |
| Last Update Date | 05/25/2022 |
| Medicare PECOS PAC ID | 3476941592 |
|---|---|
| Medicare Enrollment ID | O20211022000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396355129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Michelle P Blackston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194277152 PECOS PAC ID: 5991089237 Enrollment ID: I20170303001657 |
| Provider Name | Tenicia S Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639691447 PECOS PAC ID: 3274808456 Enrollment ID: I20171016000233 |
| Provider Name | Ashley Tyisha Sydnor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750996930 PECOS PAC ID: 4183023625 Enrollment ID: I20210603000213 |
| Provider Name | Danielle Danita Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487362265 PECOS PAC ID: 4082086764 Enrollment ID: I20230206001706 |
| Provider Name | Ranette Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093407090 PECOS PAC ID: 1153760921 Enrollment ID: I20240416000342 |
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