Healthcare Provider Details

I. General information

NPI: 1255477261
Provider Name (Legal Business Name): CATHY L STANFIELD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 S DUNDALK AVE STE 400
DUNDALK MD
21222-4273
US

IV. Provider business mailing address

223 E TIMONIUM RD
TIMONIUM MD
21093-3344
US

V. Phone/Fax

Practice location:
  • Phone: 410-220-0720
  • Fax:
Mailing address:
  • Phone: 410-955-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR086517
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberR086517
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: