Healthcare Provider Details

I. General information

NPI: 1487654083
Provider Name (Legal Business Name): GINA PATRICE MCKNIGHT-SMITH PHARMD, MBA, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8706 WINANDS RD
RANDALLSTOWN MD
21133-4036
US

IV. Provider business mailing address

8706 WINANDS RD
RANDALLSTOWN MD
21133-4036
US

V. Phone/Fax

Practice location:
  • Phone: 410-922-6542
  • Fax: 410-922-7192
Mailing address:
  • Phone: 410-922-6542
  • Fax: 410-922-7192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number14600
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number14600
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: