Healthcare Provider Details

I. General information

NPI: 1982841466
Provider Name (Legal Business Name): RACHEL SUNTHEIMER HAUSLADEN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL SUNTHEIMER (MAIDEN NAME)

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S. GREENE STREET GUDELSKY 7TH FLOOR EAST/WEST
BALTIMORE MD
21201
US

IV. Provider business mailing address

22 S. GREENE STREET GUDELSKY 7TH FLOOR EAST/WEST
BALTIMORE MD
21201
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-7221
  • Fax:
Mailing address:
  • Phone: 215-662-3487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR206627
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP010134
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: