Healthcare Provider Details

I. General information

NPI: 1497327936
Provider Name (Legal Business Name): GENEVA ACUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 BOX HILL CORPORATE CENTER DR STE E
ABINGDON MD
21009-1223
US

IV. Provider business mailing address

606 S KENWOOD AVE
BALTIMORE MD
21224-3820
US

V. Phone/Fax

Practice location:
  • Phone: 410-569-5151
  • Fax:
Mailing address:
  • Phone: 330-322-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR235216
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR235216
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: