NPIMap

Organization Active NPI

Jeaneen Mullenhard LLC

Doing business as Fundamentally Healthy

  • Clinic/Center
  • Stevensville, MD
National Provider Identifier
1649543786
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JEANEEN MULLENHARD LLC
Doing business as
Fundamentally Healthy
Practice address
801 Marion Quimby Dr
Stevensville, MD 21666-2536
Phone
(410) 570-9400
NPI assigned
Feb 21, 2012
Last updated
Feb 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeaneen Mullenhard, CRNPNPI 1609860113
Title
Owner
Phone
(410) 570-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

801 Marion Quimby Dr
Stevensville, MD 21666-2536

Mailing address

801 Marion Quimby Dr
Stevensville, MD 21666-2536
Phone (410) 570-9400

Other names 1

  • Fundamentally Healthy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1649543786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MARION QUIMBY DR",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662536",
            "telephone_number": "410-570-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MARION QUIMBY DR",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662536",
            "telephone_number": "410-570-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANEEN MULLENHARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "MULLENHARD",
        "authorized_official_first_name": "JEANEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-570-9400",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fundamentally Healthy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevensville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.