Healthcare Provider Details

I. General information

NPI: 1497322515
Provider Name (Legal Business Name): ALLY KRANNEBITTER DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 LANSDOWNE RD
BALTIMORE MD
21227-1707
US

IV. Provider business mailing address

531 WRIGHTS LN
BALTIMORE MD
21221-1641
US

V. Phone/Fax

Practice location:
  • Phone: 410-375-9167
  • Fax:
Mailing address:
  • Phone: 443-717-2302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberR217012
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: