Healthcare Provider Details

I. General information

NPI: 1548868367
Provider Name (Legal Business Name): EMILY HAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 WILKENS AVE STE 205
BALTIMORE MD
21229-4846
US

IV. Provider business mailing address

100 CORPORATE CENTER DR STE 100
CAMP HILL PA
17011-1758
US

V. Phone/Fax

Practice location:
  • Phone: 410-650-4121
  • Fax:
Mailing address:
  • Phone: 717-763-1174
  • Fax: 717-763-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR215372
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP027637
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP027637
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: