Healthcare Provider Details

I. General information

NPI: 1790486140
Provider Name (Legal Business Name): HONEY BROJAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9106 PHILADELPHIA RD STE 108
ROSEDALE MD
21237-4335
US

IV. Provider business mailing address

4613 RIDDLE DR
NOTTINGHAM MD
21236-5702
US

V. Phone/Fax

Practice location:
  • Phone: 410-682-5040
  • Fax: 410-682-5044
Mailing address:
  • Phone: 443-208-8718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR146260
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: