Provider Demographics
NPI:1518590728
Name:OPTIMAL POINT WELLNESS LLC
Entity Type:Organization
Organization Name:OPTIMAL POINT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANORUO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-390-8333
Mailing Address - Street 1:532 BALTIMORE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6119
Mailing Address - Country:US
Mailing Address - Phone:443-390-8333
Mailing Address - Fax:
Practice Address - Street 1:532 BALTIMORE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6119
Practice Address - Country:US
Practice Address - Phone:443-390-8333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-16
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty