Healthcare Provider Details

I. General information

NPI: 1871890798
Provider Name (Legal Business Name): HELEN HANNAH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 SURRATTS RD SUITE 207
CLINTON MD
20735-3362
US

IV. Provider business mailing address

8110 MAPLE LAWN BLVD STE 235
FULTON MD
20759-2694
US

V. Phone/Fax

Practice location:
  • Phone: 301-868-2300
  • Fax: 301-856-1964
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR165893
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: