Healthcare Provider Details

I. General information

NPI: 1467440859
Provider Name (Legal Business Name): PATRICIA KAY OSWALD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR STE G030
COLUMBIA MD
21044-3261
US

IV. Provider business mailing address

10 BASSWOOD CT
CATONSVILLE MD
21228-5869
US

V. Phone/Fax

Practice location:
  • Phone: 443-546-1300
  • Fax: 443-546-1301
Mailing address:
  • Phone: 410-719-0352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR066624
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: