Healthcare Provider Details

I. General information

NPI: 1174339733
Provider Name (Legal Business Name): DESIREE BROOKE MORSBERGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MAGOTHY BEACH RD
PASADENA MD
21122-4414
US

IV. Provider business mailing address

7580 BUCKINGHAM BLVD STE 220
HANOVER MD
21076-3210
US

V. Phone/Fax

Practice location:
  • Phone: 410-255-2700
  • Fax: 410-437-1962
Mailing address:
  • Phone: 410-729-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR206713
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: