Healthcare Provider Details

I. General information

NPI: 1487835443
Provider Name (Legal Business Name): KATRINA M BAILEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KATRINA M CAMPIGLIO

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAST 31ST STREET N200
BALTIMORE MD
21218
US

IV. Provider business mailing address

4502A NORTH CHARLES ST. LOYOLA UNIVERSITY MARYLAND HEALTH CENTER
BALTIMORE MD
21210
US

V. Phone/Fax

Practice location:
  • Phone: 410-516-8270
  • Fax: 410-516-4784
Mailing address:
  • Phone: 410-617-5055
  • Fax: 410-617-2173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR161734
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: