Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Magnolia Health Care LLC

Organization Family Nurse Practitioner · NPI 1154139640

Magnolia Health Care LLC provides Family Nurse Practitioner services in Gambrills, Maryland. Registered with an NPI since 2024.

In the registry since
2024
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

2407 Baneberry Ln
Gambrills, MD 21054-1992
Phone: (301) 715-3010
Fax: (410) 220-8162
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1154139640
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shaquilla Vazquez Clark — Family Nurse Practitioner · (301) 715-3010
Other names Magnolia Body Renew; Magnolia Mobile Care
NPI enumeratedDecember 30, 2024
Last updated in NPPESJanuary 2, 2026
Certification dateJanuary 2, 2026
Mailing address2407 Baneberry Ln, Gambrills, MD 21054-1992

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