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NPI Code Detail

MEDICARE: MRS. TRACI ELIZABETH ANTES MSN, RN, CPN, CPNPAC

MEDICARE: MRS. TRACI ELIZABETH ANTES MSN, RN, CPN, CPNPAC
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
1363LP0222XCritical Care Pediatric Nurse PractitionerR208920MD

General Provider Information

NPI Number : 1447672308
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACI ELIZABETH ANTES MSN, RN, CPN, CPNPAC
Provider Business Mailing Address
First Line : 1800 NEW ORLEANS ST
Second Line : SUITE 6302
City : BALTIMORE
State : MD
Zip : 21287-4904
Country : US
Telephone Number : 404-432-7273
Fax Number :
Provider Business Practice Location Address
First Line : 1800 NEW ORLEANS ST
Second Line : SUITE 6302
City : BALTIMORE
State : MD
Zip : 21287-4904
Country : US
Telephone Number : 404-432-7273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2014
Last Update Date : 01/13/2014

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