Provider Demographics
NPI:1689459489
Name:HEART OWN MEDICAL SERVICES
Entity Type:Organization
Organization Name:HEART OWN MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SYDNOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-827-3802
Mailing Address - Street 1:3905 EDNOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2054
Mailing Address - Country:US
Mailing Address - Phone:443-827-3802
Mailing Address - Fax:
Practice Address - Street 1:3905 EDNOR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2054
Practice Address - Country:US
Practice Address - Phone:443-827-3802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty