Healthcare Provider Details

I. General information

NPI: 1760657662
Provider Name (Legal Business Name): PATRICIA S DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 WASHINGTON RD SUITE 102
WESTMINSTER MD
21157-6664
US

IV. Provider business mailing address

PO BOX 900
WESTMINSTER MD
21158-0900
US

V. Phone/Fax

Practice location:
  • Phone: 410-871-0088
  • Fax: 410-871-0083
Mailing address:
  • Phone: 410-871-0088
  • Fax: 410-871-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR124460
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: