Provider Demographics
NPI:1811693559
Name:VISIONARY PROFESSIONAL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:VISIONARY PROFESSIONAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:U
Authorized Official - Last Name:ACHOLONU
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-FNP-BC, PMH-BC
Authorized Official - Phone:301-377-9800
Mailing Address - Street 1:14114 JONES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8860
Mailing Address - Country:US
Mailing Address - Phone:301-377-9800
Mailing Address - Fax:
Practice Address - Street 1:14114 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8860
Practice Address - Country:US
Practice Address - Phone:301-377-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISIONARY PROFESSIONAL HEALHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty