Divine Healthcare
Organization Active NPI Family Nurse Practitioner · Severn, MD
NPI 1003433079 · NPPES record last updated Nov 5, 2021
Key facts
- NPI
- 1003433079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- DIVINE HEALTHCARE
- Practice address
- 1778 Grande View Ave
Severn, MD 21144-3333 - Phone
- (410) 551-5849
- Fax
- (410) 551-0685
- NPI assigned
- Jun 25, 2020
- Organization subpart
- No
Authorized official
- Name
- Abimbola Hillard, FNP-BC
- Title
- President
- Phone
- (240) 501-8616
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
1778 Grande View Ave
Severn, MD 21144-3333
Mailing address
1778 Grande View Ave
Severn, MD 21144-3333
Phone (410) 551-5849
Other providers in Severn, MD
- Desai Physical Therapy Inc
- Brice Diagong
- Augustus Dickens
- Kassandra A Dickens
- Oluchi Dike
- Divine Healthcare
- Divine Solutions
- Prajakta Dravid
- Shannon Leigh Drechsler
- Emade Ebah Edongole
All providers in Severn, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.