| Pediatric Health Connect Llc | |
|
1302 Cronson Blvd Ste J Crofton MD 21114-2064 | |
| (301) 467-5033 | |
| Not Available |
| Full Name | Pediatric Health Connect Llc |
|---|---|
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 1302 Cronson Blvd Ste J, Crofton, Maryland |
| Authorized Official Name and Position | Chauntelle Ellis (NURSE PRACTITIONER) |
| Authorized Official Contact | 3014675033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Health Connect Llc 2421 Vineyard Ln Crofton MD 21114-1138 Ph: (301) 467-5033 | Pediatric Health Connect Llc 1302 Cronson Blvd Ste J Crofton MD 21114-2064 Ph: (301) 467-5033 |
| NPI Number | 1285510685 |
|---|---|
| Provider Enumeration Date | 08/12/2025 |
| Last Update Date | 08/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285510685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | (* (Not Available)) | Primary |
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