Organization Name: | SEVA HEALTH, LLC |
NPI Number: | 1083022966 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGEL V SHANNON (EXECUTIVE DIRECTOR) |
Mailing Address: | 9133 Sunset Ridge Rd Randallstown |
State: | MD US |
Postal Code: | 211333651 |
Phone Number: | 4102993803 |
Fax Number: | |
NPI Enumeration Date: | 07/23/2014 |
NPI Last Update Date: | 07/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | R121021 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |