Healthcare Provider Details

I. General information

NPI: 1043426885
Provider Name (Legal Business Name): REBECCA M DAMORE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2772 RUTLAND RD
DAVIDSONVILLE MD
21035-1228
US

IV. Provider business mailing address

1104 JENNIPER LN
ANNAPOLIS MD
21403-4211
US

V. Phone/Fax

Practice location:
  • Phone: 443-332-4260
  • Fax:
Mailing address:
  • Phone: 585-230-3560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR164990
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR164990
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: