Provider Demographics
NPI:1922761691
Name:MODERN BLISS HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:MODERN BLISS HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:APPIAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-331-5006
Mailing Address - Street 1:4939 LOCKARD DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6178
Mailing Address - Country:US
Mailing Address - Phone:443-331-5006
Mailing Address - Fax:
Practice Address - Street 1:9722 GROFFS MILL DR STE 868
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6341
Practice Address - Country:US
Practice Address - Phone:443-331-5006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty