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General NPI Number Information
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NPI Number | 1467766246
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Entity Type | Individual
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Provider Name | ELAINE MARIE SLEAR CRNP-A
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 705 DIGITAL DR STE G
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City | LINTHICUM
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State | MD
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Zip | 21090-2267
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Country | US
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Telephone | 410-636-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 2003 W FULTON ST
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City | CHICAGO
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State | IL
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Zip | 60612-2345
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Country | US
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Telephone | 177-329-2480
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0047878-21
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License Number State | MD
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