| Your Wellness Sources | |
|
4301 Garden City Dr Ste 304 Hyattsville MD 20785-6105 | |
| (301) 235-0060 | |
| (240) 324-7720 |
| Full Name | Your Wellness Sources |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4301 Garden City Dr Ste 304, Hyattsville, Maryland |
| Authorized Official Name and Position | Marshalee George (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3012350060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Wellness Sources 4301 Garden City Dr Ste 304 Hyattsville MD 20785-6105 Ph: (301) 235-0600 | Your Wellness Sources 4301 Garden City Dr Ste 304 Hyattsville MD 20785-6105 Ph: (301) 235-0060 |
| NPI Number | 1780031724 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 03/08/2024 |
| Certification Date | 03/08/2024 |
| Medicare PECOS PAC ID | 2668751454 |
|---|---|
| Medicare Enrollment ID | O20161118000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780031724 | NPI | - | NPPES |
| 051747821 | Medicaid | DC | |
| 600082700 | Medicaid | MD | |
| 540582 | Other | MD | MEDICARE PTAN |
| Provider Name | Marshalee George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952370272 PECOS PAC ID: 6507880341 Enrollment ID: I20161118000925 |
| Provider Name | Jaime Durant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154690766 PECOS PAC ID: 2567684277 Enrollment ID: I20161128000378 |
| Provider Name | Ngozi Mewe-pira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336364082 PECOS PAC ID: 5294801692 Enrollment ID: I20161129001121 |
| Provider Name | Johanese Sandy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154819977 PECOS PAC ID: 1153674734 Enrollment ID: I20181029002026 |
| Provider Name | Patrick Kaguamba Nganga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982916607 PECOS PAC ID: 8426244500 Enrollment ID: I20191018000818 |
| Provider Name | Zainab Koroma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154987923 PECOS PAC ID: 4082035167 Enrollment ID: I20200527001903 |
| Provider Name | Ekere Ekandem Olojola |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922490218 PECOS PAC ID: 7719301720 Enrollment ID: I20200723002123 |
| Provider Name | Melani Dhason |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720696206 PECOS PAC ID: 8325464316 Enrollment ID: I20200820003843 |
| Provider Name | Dhaya Nandipamu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992371157 PECOS PAC ID: 4981077195 Enrollment ID: I20230308001215 |
| Provider Name | Shelby Ann Wright |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1164091724 PECOS PAC ID: 7719350990 Enrollment ID: I20230309000980 |
| Provider Name | Laverne Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275168478 PECOS PAC ID: 3779993001 Enrollment ID: I20230420003165 |
| Provider Name | Akos Antwi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760966436 PECOS PAC ID: 9436567617 Enrollment ID: I20230504002870 |
| Provider Name | Tillie Mirsky |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1174226591 PECOS PAC ID: 0244689172 Enrollment ID: I20231218001079 |
| Provider Name | Susan Marie Lopez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1588219059 PECOS PAC ID: 5395195242 Enrollment ID: I20231219002379 |
| Provider Name | Melissa M Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083133318 PECOS PAC ID: 1759739089 Enrollment ID: I20240215003377 |
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