Healthcare Provider Details

I. General information

NPI: 1629427109
Provider Name (Legal Business Name): ELIZABETH DABNEY PEARCE JOHNSTON CRNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST STE 650
BALTIMORE MD
21218-6516
US

IV. Provider business mailing address

3333 N CALVERT ST STE 650
BALTIMORE MD
21218-6516
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-7333
  • Fax: 410-554-7334
Mailing address:
  • Phone: 410-554-7333
  • Fax: 410-554-7334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR201041
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR201041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: