Provider Demographics
NPI:1780041012
Name:HEALTHWISE
Entity Type:Organization
Organization Name:HEALTHWISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY-RITA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLUTE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-235-3854
Mailing Address - Street 1:PO BOX 19951
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-0951
Mailing Address - Country:US
Mailing Address - Phone:410-235-3854
Mailing Address - Fax:410-235-3854
Practice Address - Street 1:2620 N CALVERT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4616
Practice Address - Country:US
Practice Address - Phone:410-235-3854
Practice Address - Fax:410-235-3854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134703163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty