Provider Demographics
NPI:1699513192
Name:BERUR HEALTH & WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:BERUR HEALTH & WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:NORAH
Authorized Official - Middle Name:JEMUTAI
Authorized Official - Last Name:TIO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:952-992-9162
Mailing Address - Street 1:6011 VALENTINE WAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2363
Mailing Address - Country:US
Mailing Address - Phone:952-992-9162
Mailing Address - Fax:
Practice Address - Street 1:6011 VALENTINE WAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-2363
Practice Address - Country:US
Practice Address - Phone:952-992-9162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERUR HEALTH & WELLNESS SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty