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General NPI Number Information
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NPI Number | 1053275149
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Entity Type | Organization
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Legal Business Name | CHARLES COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4202 INDIAN HEAD HIGHWAY
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City | INDIAN HEAD
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State | MD
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Zip | 20640-0000
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Country | US
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Telephone | 301-609-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 CRAIN HWY
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City | WHITE PLAINS
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State | MD
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Zip | 20695-3045
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Country | US
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Telephone | 301-609-6900
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Fax |
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Authorized Official
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Title or Position | DEPUTY HEALTH OFFICER
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Name | KAREN WALDBAUER
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Credential |
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Telephone | 301-609-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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