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NPI Code Detail

MEDICARE: MS. MARIE BERNADETTE WAITERS RN

MEDICARE: MS. MARIE BERNADETTE WAITERS RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN44491DC
2163WA0400XAddiction (Substance Use Disorder) Registered NurseRN44491DC

General Provider Information

NPI Number : 1417286014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIE BERNADETTE WAITERS RN
Provider Business Mailing Address
First Line : PO BOX 23
Second Line :
City : BRANDYWINE
State : MD
Zip : 20613-0023
Country : US
Telephone Number : 301-535-0741
Fax Number : 301-579-2660
Provider Business Practice Location Address
First Line : 2918 MINNESOTA AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-1127
Country : US
Telephone Number : 301-535-0741
Fax Number : 301-579-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2009
Last Update Date : 07/01/2024

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