Healthcare Provider Details

I. General information

NPI: 1730259979
Provider Name (Legal Business Name): YVONNE D MACKLIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 06/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 YORK RD
BALTIMORE MD
21212-2152
US

IV. Provider business mailing address

6401 YORK RD
BALTIMORE MD
21212-2152
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-2243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: