Healthcare Provider Details

I. General information

NPI: 1215680921
Provider Name (Legal Business Name): SMRITI SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 N LA PLATA CT STE 101
LA PLATA MD
20646-5207
US

IV. Provider business mailing address

900 ELKRIDGE LANDING RD
LINTHICUM HEIGHTS MD
21090-2924
US

V. Phone/Fax

Practice location:
  • Phone: 301-609-5044
  • Fax: 301-934-4304
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number35457
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC006339
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number233458
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: