Healthcare Provider Details

I. General information

NPI: 1659490258
Provider Name (Legal Business Name): NANCY AGNES CALABRESE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 COLLEGE AVE
ANNAPOLIS MD
21401-1687
US

IV. Provider business mailing address

1300 ARGYLL DR
ARNOLD MD
21012-2104
US

V. Phone/Fax

Practice location:
  • Phone: 410-626-2553
  • Fax: 410-626-2889
Mailing address:
  • Phone: 410-544-4687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License NumberR063769
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: