Healthcare Provider Details

I. General information

NPI: 1689013344
Provider Name (Legal Business Name): ERIN CLARE RUANE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 MEDICAL CENTER DR. #221
ROCKVILLE MD
20850
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR. #327
OLNEY MD
20832
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-7510
  • Fax: 301-279-7295
Mailing address:
  • Phone: 301-774-6136
  • Fax: 301-570-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR134789
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR134789
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: