Healthcare Provider Details

I. General information

NPI: 1285154336
Provider Name (Legal Business Name): ANNA JANE CAPP TELEWICZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA JANE CAPP

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SAINT PAUL ST
BALTIMORE MD
21202-2001
US

IV. Provider business mailing address

28 HUNTING HORN CIR
REISTERSTOWN MD
21136-5326
US

V. Phone/Fax

Practice location:
  • Phone: 410-783-5858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR197354
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: