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General NPI Number Information
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NPI Number | 1083941355
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Entity Type | Individual
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Provider Name | CHARDAE ANDREA WEEMS
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Gender | Female
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 604 SCHOOL ST
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City | BALTIMORE
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State | MD
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Zip | 21217-2828
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Country | US
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Telephone | 410-736-9683
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Fax | 410-669-3829
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Provider Business Mailing Address
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Address Line | 1508 PENNSYLVANIA AVE APT 10
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City | BALTIMORE
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State | MD
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Zip | 21217-3111
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Country | US
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Telephone | 410-736-9683
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Fax | 410-669-3829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | A00082196
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License Number State | MD
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