Healthcare Provider Details

I. General information

NPI: 1225097835
Provider Name (Legal Business Name): DEBORAH A NEEDLE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 GENERALS HWY STE 101B
CROWNSVILLE MD
21032-2060
US

IV. Provider business mailing address

1557 SAINT MARGARETS RD
ANNAPOLIS MD
21409-5554
US

V. Phone/Fax

Practice location:
  • Phone: 443-837-6314
  • Fax:
Mailing address:
  • Phone: 443-838-5914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR146447
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: