=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114814464
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAUDIA MARIE DORSEY CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2025
-----------------------------------------------------
Last Update Date | 06/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 770 OLD LIBERTY RD STE 3
-----------------------------------------------------
City | ELDERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21784-8500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-970-8480
-----------------------------------------------------
Fax | 855-576-5073
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 770 OLD LIBERTY RD STE 3
-----------------------------------------------------
City | ELDERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21784-8500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-970-8480
-----------------------------------------------------
Fax | 855-576-5073
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | R238826
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------