Provider Demographics
NPI:1629592738
Name:INFINITE MEDICAL EXPRESS LLC
Entity Type:Organization
Organization Name:INFINITE MEDICAL EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ANTONETTE
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP FNP-BC
Authorized Official - Phone:410-671-6900
Mailing Address - Street 1:1401 PULASKI HWY STE W
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1398
Mailing Address - Country:US
Mailing Address - Phone:410-671-6900
Mailing Address - Fax:
Practice Address - Street 1:1401 PULASKI HWY STE W
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1398
Practice Address - Country:US
Practice Address - Phone:410-671-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine