Healthcare Provider Details

I. General information

NPI: 1184064941
Provider Name (Legal Business Name): CHRISTOPHER JAMES ROBERSON CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LINDEN AVE STE B
BALTIMORE MD
21201-4606
US

IV. Provider business mailing address

877 1/2 W LOMBARD ST
BALTIMORE MD
21201-1061
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5487
  • Fax: 410-328-4430
Mailing address:
  • Phone: 443-857-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR179907
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR179907
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR179907
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: