Healthcare Provider Details

I. General information

NPI: 1326018664
Provider Name (Legal Business Name): LINDA CRUM MUEHL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 THOMAS JOHNSON DR
FREDERICK MD
21702-4679
US

IV. Provider business mailing address

PO BOX 37086
BALTIMORE MD
21297-3086
US

V. Phone/Fax

Practice location:
  • Phone: 240-215-6370
  • Fax:
Mailing address:
  • Phone: 240-439-8913
  • Fax: 240-439-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR069310
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: