Healthcare Provider Details

I. General information

NPI: 1326065905
Provider Name (Legal Business Name): LINDA P WEISBURGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N WARWICK AVE
BALTIMORE MD
21216
US

IV. Provider business mailing address

711 WHITE SWAN DR
ARNOLD MD
21012
US

V. Phone/Fax

Practice location:
  • Phone: 410-396-0849
  • Fax: 410-545-3614
Mailing address:
  • Phone: 410-974-1906
  • Fax: 410-974-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRO48679
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: