Healthcare Provider Details

I. General information

NPI: 1386967545
Provider Name (Legal Business Name): RITA ABU-JABER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHNS HOPKINS OUTPATIENT CTR 601 N. CAROLINE ST. RM 5240
BALTIMORE MD
21287-0001
US

IV. Provider business mailing address

PO BOX 64664
BALTIMORE MD
21264-4664
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-1796
  • Fax:
Mailing address:
  • Phone: 443-854-7896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberR142889
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: