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General NPI Number Information
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NPI Number | 1306449905
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Entity Type | Individual
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Provider Name | KARINAGRACE ANDAYA SHOULDICE LPN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 1838 GREENE TREE RD STE 260
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City | PIKESVILLE
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State | MD
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Zip | 21208-7108
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Country | US
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Telephone | 410-486-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 CARRBRIDGE CIR
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City | TOWSON
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State | MD
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Zip | 21204-1812
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Country | US
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Telephone | 360-348-2999
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 5238810
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License Number State | FL
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