Provider Demographics
NPI:1114523495
Name:CAMBIARE HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:CAMBIARE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTICIONER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP OWNER
Authorized Official - Phone:443-554-6173
Mailing Address - Street 1:21 W COURTLAND ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3701
Mailing Address - Country:US
Mailing Address - Phone:443-554-6173
Mailing Address - Fax:
Practice Address - Street 1:21 W COURTLAND ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3701
Practice Address - Country:US
Practice Address - Phone:443-554-6173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care