Advanced Functional Health and Wellness, LLC.

Organization Active NPI Family Nurse Practitioner · Frederick, MD

NPI 1366031973 · NPPES record last updated Jan 24, 2023

Key facts

NPI
1366031973
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
ADVANCED FUNCTIONAL HEALTH AND WELLNESS, LLC.
Practice address
1003 W 7TH St Ste B
Frederick, MD 21701-4153
Phone
(301) 966-2558
NPI assigned
Jan 18, 2021
Organization subpart
No

Authorized official

Name
Louis Gbone
Title
Manager
Phone
(301) 966-2558

National Provider Directory

Locations

1003 W 7th St
Ste B
Frederick, MD 21701
Phone (301) 966-2558

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X Yes

Addresses

Primary practice location

1003 W 7TH St Ste B
Frederick, MD 21701-4153

Mailing address

1003 W 7TH St Ste B
Frederick, MD 21701-4153
Phone (301) 966-2558

Other providers in Frederick, MD

All providers in Frederick, MD · Family Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.