Healthcare Provider Details

I. General information

NPI: 1861848798
Provider Name (Legal Business Name): KRISTA MARIE COLOPINTO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST ZAYED 8 EAST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1101 SAINT PAUL ST APT 608
BALTIMORE MD
21202-2619
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5850
  • Fax:
Mailing address:
  • Phone: 856-906-3904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR206092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: