Healthcare Provider Details

I. General information

NPI: 1952461485
Provider Name (Legal Business Name): CORNELIA ELLEN PAPPAS APRN,B.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 N CHARLES ST JOHNS HOPKINS UNIVERSITY AMR 2 STUDENT HEALTH CENTER
BALTIMORE MD
21218-2608
US

IV. Provider business mailing address

1808 RIVER WATCH LN
ANNAPOLIS MD
21401-2009
US

V. Phone/Fax

Practice location:
  • Phone: 410-516-8073
  • Fax: 410-516-4784
Mailing address:
  • Phone: 410-841-2580
  • Fax: 410-224-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRO75892
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: