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General NPI Number Information
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NPI Number | 1689684136
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Entity Type | Individual
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Provider Name | CAROL D. FORSYTH C.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 692 RITCHIE HWY # A
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City | SEVERNA PARK
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State | MD
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Zip | 21146-3919
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Country | US
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Telephone | 410-544-5141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6429
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City | ANNAPOLIS
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State | MD
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Zip | 21401-0429
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Country | US
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Telephone |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R128058
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License Number State | MD
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