Healthcare Provider Details

I. General information

NPI: 1578753992
Provider Name (Legal Business Name): ELAYNE F TROMPETER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 COUNTRY RIDGE LN
BALTIMORE MD
21221-3906
US

IV. Provider business mailing address

1528 COUNTRY RIDGE LN
BALTIMORE MD
21221-3906
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-0246
  • Fax: 410-887-0243
Mailing address:
  • Phone: 410-887-0246
  • Fax: 410-887-0243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRO43498
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: