Organization · Type 2 NPI
Providence Health Group LLC
Psychiatric/Mental Health Nurse Practitioner · Bowie, MD
NPI number
1205773264
Active
Practice location
3060 Mitchellville Rd # 6-A
Bowie, MD 20716-1389
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1205773264
Providence Health Group LLC's National Provider Identifier is 1205773264, issued on Apr 29, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Bowie, MD. The record was last updated on Aug 6, 2026.