NPI Profile for A CLEAN START LLC in PIKESVILLE, MD.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI Number | 1821707944 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/17/2022 | |
| Last updated | 12/01/2022 - About 4 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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A CLEAN START LLC
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