Provider Demographics
NPI:1891486551
Name:ALLWELL FAMILY PRACTICE, LLC
Entity Type:Organization
Organization Name:ALLWELL FAMILY PRACTICE, LLC
Other - Org Name:ALLWELL FAMILY PRACTICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:UZOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC, CRNP
Authorized Official - Phone:410-864-1800
Mailing Address - Street 1:1900 E NORTHERN PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2110
Mailing Address - Country:US
Mailing Address - Phone:443-570-3825
Mailing Address - Fax:410-864-1717
Practice Address - Street 1:1900 E NORTHERN PKWY STE 208
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2110
Practice Address - Country:US
Practice Address - Phone:410-864-1800
Practice Address - Fax:410-864-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty