Healthcare Provider Details

I. General information

NPI: 1659587210
Provider Name (Legal Business Name): MARYFRAN WINKLER CRIMONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICKIE WINKLER CRIMONE APRN

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 EXECUTIVE BLVD
ROCKVILLE MD
20852-3906
US

IV. Provider business mailing address

10601 WILLOWBROOK DR
POTOMAC MD
20854-4457
US

V. Phone/Fax

Practice location:
  • Phone: 301-299-7475
  • Fax: 301-299-9511
Mailing address:
  • Phone: 301-299-7475
  • Fax: 301-299-9511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRO49675
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: