Provider Demographics
NPI:1548612799
Name:MOBILE NP LLC
Entity Type:Organization
Organization Name:MOBILE NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:HOLLAND-BARNER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-963-5535
Mailing Address - Street 1:3927 MCDONOGH RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3633
Mailing Address - Country:US
Mailing Address - Phone:410-963-5535
Mailing Address - Fax:410-655-2969
Practice Address - Street 1:3927 MCDONOGH RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-3633
Practice Address - Country:US
Practice Address - Phone:410-963-5535
Practice Address - Fax:410-655-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR158140261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1437133873OtherNPI NUMBER