Healthcare Provider Details

I. General information

NPI: 1265672182
Provider Name (Legal Business Name): GEORGE-MARIE TONIA GARBER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 WILKENS AVE STE 302
BALTIMORE MD
21229-4845
US

IV. Provider business mailing address

2 PARK CENTER CT STE 200
OWINGS MILLS MD
21117-4221
US

V. Phone/Fax

Practice location:
  • Phone: 855-527-7246
  • Fax: 866-229-5063
Mailing address:
  • Phone: 855-527-7246
  • Fax: 866-229-5063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number648947
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR232736
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: