Healthcare Provider Details

I. General information

NPI: 1346678992
Provider Name (Legal Business Name): ASHLEY MARIE ZINALABEDINI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARIE GIBBS

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 ANNAPOLIS RD
ODENTON MD
21113-1647
US

IV. Provider business mailing address

1132 ANNAPOLIS RD
ODENTON MD
21113-1647
US

V. Phone/Fax

Practice location:
  • Phone: 410-874-1455
  • Fax: 410-874-1471
Mailing address:
  • Phone: 410-874-1455
  • Fax: 410-874-1471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR176649
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: