Healthcare Provider Details

I. General information

NPI: 1013247717
Provider Name (Legal Business Name): ALEXANDRA TALBOTT MORREL CRNP-F
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA SPENCER TALBOTT

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 N CHARLES ST N200
BALTIMORE MD
21218-3855
US

IV. Provider business mailing address

3003 N CHARLES ST N200
BALTIMORE MD
21218-3855
US

V. Phone/Fax

Practice location:
  • Phone: 410-516-6190
  • Fax: 410-516-4784
Mailing address:
  • Phone: 410-516-6190
  • Fax: 410-516-4784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR161592
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: