Healthcare Provider Details

I. General information

NPI: 1164940656
Provider Name (Legal Business Name): TARNISHA FITZGERALD CRNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2232 E MONUMENT ST
BALTIMORE MD
21205-2431
US

IV. Provider business mailing address

2232 E MONUMENT ST
BALTIMORE MD
21205-2431
US

V. Phone/Fax

Practice location:
  • Phone: 667-207-3552
  • Fax:
Mailing address:
  • Phone: 667-207-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025111975
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR188175
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: