Provider Demographics
NPI:1427670090
Name:ASTEN NURSING AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ASTEN NURSING AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:UMEUGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-605-2479
Mailing Address - Street 1:11400 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2122
Mailing Address - Country:US
Mailing Address - Phone:240-605-2479
Mailing Address - Fax:
Practice Address - Street 1:11400 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2122
Practice Address - Country:US
Practice Address - Phone:240-605-2479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-17
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty