Healthcare Provider Details

I. General information

NPI: 1366549453
Provider Name (Legal Business Name): PATSY ANN ARDINGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W PRESTON ST
BALTIMORE MD
21201-2301
US

IV. Provider business mailing address

18515 KENT AVE
HAGERSTOWN MD
21740-9557
US

V. Phone/Fax

Practice location:
  • Phone: 410-767-5726
  • Fax:
Mailing address:
  • Phone: 301-733-1953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRO40624
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: