Healthcare Provider Details

I. General information

NPI: 1013334218
Provider Name (Legal Business Name): DANIELLE CHEPLOWITZ AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MAGOTHY BEACH RD
PASADENA MD
21122-4414
US

IV. Provider business mailing address

117 KIRWANS LANDING LN
CHESTER MD
21619-2649
US

V. Phone/Fax

Practice location:
  • Phone: 410-255-2700
  • Fax:
Mailing address:
  • Phone: 443-791-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR189564
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: