Healthcare Provider Details

I. General information

NPI: 1932162187
Provider Name (Legal Business Name): LILLIAN R AWAR CRNP-ADULT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. LILLIAN R TAYLOR

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 N. ROLLING RD
WINDSOR MILL MD
21244
US

IV. Provider business mailing address

3110 N. ROLLING RD
WINDSOR MILL MD
21244
US

V. Phone/Fax

Practice location:
  • Phone: 410-298-1931
  • Fax: 410-298-1932
Mailing address:
  • Phone: 410-298-1931
  • Fax: 410-298-1932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR094180
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAC000143
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR094180
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: