Healthcare Provider Details

I. General information

NPI: 1215212964
Provider Name (Legal Business Name): CATHERINE GVOZDEN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 RITCHIE HWY STE 201
ARNOLD MD
21012-2706
US

IV. Provider business mailing address

1521 RITCHIE HWY STE 201
ARNOLD MD
21012-2706
US

V. Phone/Fax

Practice location:
  • Phone: 443-354-4504
  • Fax: 443-352-0685
Mailing address:
  • Phone: 443-354-4504
  • Fax: 443-352-0685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR069649
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: