Healthcare Provider Details

I. General information

NPI: 1275265050
Provider Name (Legal Business Name): EMMA VARNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST
BALTIMORE MD
21287-0011
US

IV. Provider business mailing address

8181 ROBINSON JEFFERSON DR APT 314
ELKRIDGE MD
21075-7270
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-6132
  • Fax:
Mailing address:
  • Phone: 240-565-4985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR222523
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: