Healthcare Provider Details

I. General information

NPI: 1366798316
Provider Name (Legal Business Name): KAREN ARMACOST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE MASON LORD BUILDING, EAST TOWER, FIRST FLOOR
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

3 CREEK SIDE CT
BALTIMORE MD
21220-5605
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-7044
  • Fax:
Mailing address:
  • Phone: 410-918-9794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRO62510
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: