Provider Demographics
NPI:1104492073
Name:WELLSVIEWCARE LLC
Entity type:Organization
Organization Name:WELLSVIEWCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:K R
Authorized Official - Last Name:MAHOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MAC / LAC
Authorized Official - Phone:410-266-5608
Mailing Address - Street 1:611 RIDGELY AVENUE
Mailing Address - Street 2:WELLSVIEW COTTAGE CENTER
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:410-353-3003
Mailing Address - Fax:
Practice Address - Street 1:613 RIDGELY AVE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1069
Practice Address - Country:US
Practice Address - Phone:410-266-5608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1346531183OtherLAC
MD1134378334OtherCRNP