Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health Group LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1205773264

Providence Health Group LLC is a Psychiatric/Mental Health Nurse Practitioner in Bowie, Maryland. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3060 Mitchellville Rd # 6-A
Bowie, MD 20716-1389
Phone: (908) 906-7518
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1205773264
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ijeoma Mgboji — Owner · (908) 906-7518
NPI enumeratedApril 29, 2026
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026
Mailing address3060 Mitchellville Rd # 6-A, Bowie, MD 20716-1389

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