Healthcare Provider Details

I. General information

NPI: 1578077566
Provider Name (Legal Business Name): CATHERINE M WILLMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 08/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W. PRATT STREET
BALTIMORE MD
21223
US

IV. Provider business mailing address

1001 W. PRATT STREET
BALTIMORE MD
21223
US

V. Phone/Fax

Practice location:
  • Phone: 443-462-3400
  • Fax: 443-462-3086
Mailing address:
  • Phone: 443-462-3400
  • Fax: 443-462-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR210368
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: