Provider Demographics
NPI:1134791783
Name:ISURA MATERNAL & CHILD SERVICES LLC
Entity type:Organization
Organization Name:ISURA MATERNAL & CHILD SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP-PC, CLC
Authorized Official - Phone:301-690-9427
Mailing Address - Street 1:324 MAIN ST UNIT 1036
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-7545
Mailing Address - Country:US
Mailing Address - Phone:301-690-9427
Mailing Address - Fax:866-492-0362
Practice Address - Street 1:8108 MALLARD SHORE DR.
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724
Practice Address - Country:US
Practice Address - Phone:301-690-9427
Practice Address - Fax:866-492-0362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty