Healthcare Provider Details

I. General information

NPI: 1316741317
Provider Name (Legal Business Name): SASHAMARA PEREZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 07/15/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N CHARLES ST
BALTIMORE MD
21201-5505
US

IV. Provider business mailing address

1802 10TH ST NW APT BSMT
WASHINGTON DC
20001-5000
US

V. Phone/Fax

Practice location:
  • Phone: 410-837-2050
  • Fax: 443-573-5023
Mailing address:
  • Phone: 202-802-2995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR264014
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR264014
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN200003440
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: