Healthcare Provider Details

I. General information

NPI: 1215709795
Provider Name (Legal Business Name): DEVORAH WEINSCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 KNOLL NORTH DR
COLUMBIA MD
21045-2373
US

IV. Provider business mailing address

6204 LINCOLN AVE
BALTIMORE MD
21209-3325
US

V. Phone/Fax

Practice location:
  • Phone: 410-964-6227
  • Fax:
Mailing address:
  • Phone: 773-331-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR232042
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: