Healthcare Provider Details

I. General information

NPI: 1508898628
Provider Name (Legal Business Name): CRISTINA RUMBAOA BAGAYMETCALF CRNP-FAMILY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAMEDDAC 2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755
US

IV. Provider business mailing address

USAMEDDAC 2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755
US

V. Phone/Fax

Practice location:
  • Phone: 410-278-5475
  • Fax:
Mailing address:
  • Phone: 410-278-5475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR122689
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: