Healthcare Provider Details

I. General information

NPI: 1225249329
Provider Name (Legal Business Name): PATRICIA GIANNACCINI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3903
US

IV. Provider business mailing address

1602 MORNING BROOK CT
FOREST HILL MD
21050-2630
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-6456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR151064
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: