Provider Demographics
NPI:1215789326
Name:ADVITA HEALTH LLC
Entity type:Organization
Organization Name:ADVITA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-618-3459
Mailing Address - Street 1:979 COACHWAY
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6413
Mailing Address - Country:US
Mailing Address - Phone:443-618-3459
Mailing Address - Fax:
Practice Address - Street 1:1910 TOWNE CENTRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3599
Practice Address - Country:US
Practice Address - Phone:443-618-3459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty