Healthcare Provider Details

I. General information

NPI: 1619005964
Provider Name (Legal Business Name): MARIA ANNA PERROTTA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR CAMPUS DRIVE, BUILDING #140
COLLEGE PARK MD
20742-0001
US

IV. Provider business mailing address

UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR CAMPUS DRIVE, BUILDING #140
COLLEGE PARK MD
20742-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-314-8149
  • Fax: 301-405-9755
Mailing address:
  • Phone: 301-314-8149
  • Fax: 301-405-9755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR057103
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: