Provider Demographics
NPI:1043778160
Name:A PLATFORM TO HEALTHCARE
Entity type:Organization
Organization Name:A PLATFORM TO HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-562-5655
Mailing Address - Street 1:325 AHERN DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-3410
Mailing Address - Country:US
Mailing Address - Phone:443-562-5655
Mailing Address - Fax:
Practice Address - Street 1:325 AHERN DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3410
Practice Address - Country:US
Practice Address - Phone:443-562-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty