Healthcare Provider Details

I. General information

NPI: 1861894974
Provider Name (Legal Business Name): PATRICIA KARPOOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 FRANKLIN SQUARE DR SUITE 200
BALTIMORE MD
21237-3903
US

IV. Provider business mailing address

9100 FRANKLIN SQUARE DR SUITE 200
BALTIMORE MD
21237-3903
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-2221
  • Fax: 443-777-2245
Mailing address:
  • Phone: 443-777-2221
  • Fax: 443-777-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR041179
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: