Healthcare Provider Details

I. General information

NPI: 1316770985
Provider Name (Legal Business Name): ASHLEY ELIZABETH FAIELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2077 SOMERVILLE RD
ANNAPOLIS MD
21401-4177
US

IV. Provider business mailing address

65 WINDWHISPER LN
ANNAPOLIS MD
21403-3474
US

V. Phone/Fax

Practice location:
  • Phone: 410-497-8909
  • Fax:
Mailing address:
  • Phone: 330-410-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR268070
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: