Healthcare Provider Details

I. General information

NPI: 1134615024
Provider Name (Legal Business Name): BRYNN M FARLOW CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 M ST NW
WASHINGTON DC
20037-1434
US

IV. Provider business mailing address

812 S PORT ST
BALTIMORE MD
21224-3651
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2650
  • Fax:
Mailing address:
  • Phone: 443-564-6047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR214825
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberNP500015049
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: