Healthcare Provider Details

I. General information

NPI: 1790217180
Provider Name (Legal Business Name): CATHLEEN MARIE PIRNER FNP,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHLEEN MARIE HAYDEN

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14090 HG TRUEMAN RD STE 2500
SOLOMONS MD
20688-3151
US

IV. Provider business mailing address

985 PRINCE FREDERICK BLVD STE 201
PRINCE FREDERICK MD
20678-3492
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-2005
  • Fax: 410-535-4850
Mailing address:
  • Phone: 410-535-2005
  • Fax: 410-535-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR186175
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: