Healthcare Provider Details

I. General information

NPI: 1568347797
Provider Name (Legal Business Name): MARIA DELMIRA MENDOZA MSN, APRN, CPNP-PC/A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

807 SOMERSET PL
HYATTSVILLE MD
20783-3114
US

V. Phone/Fax

Practice location:
  • Phone: 401-601-4399
  • Fax:
Mailing address:
  • Phone: 301-385-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR243248
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP1052732
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR243248
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR243248
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: