Provider Demographics
NPI:1699356881
Name:ANTORIAN CONSULTING SERVICES
Entity Type:Organization
Organization Name:ANTORIAN CONSULTING SERVICES
Other - Org Name:ANTORIAN HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AN'NITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE-HEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-246-2830
Mailing Address - Street 1:3545 ELLICOTT MILLS DR PMB 204
Mailing Address - Street 2:PMB 204
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4513
Mailing Address - Country:US
Mailing Address - Phone:410-246-2830
Mailing Address - Fax:
Practice Address - Street 1:7004 SECURITY BLVD # 300-A27
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2557
Practice Address - Country:US
Practice Address - Phone:410-246-2830
Practice Address - Fax:410-246-2831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTORIAN CONSULTING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-19
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty