Healthcare Provider Details

I. General information

NPI: 1447450184
Provider Name (Legal Business Name): CASSANDRA RICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD
BALTIMORE MD
21239-2950
US

IV. Provider business mailing address

5601 LOCH RAVEN BLVD
BALTIMORE MD
21239-2950
US

V. Phone/Fax

Practice location:
  • Phone: 443-444-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR187964
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: