=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942857917
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH MAINSTAIN FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2019
-----------------------------------------------------
Last Update Date | 01/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2702 GEARTNER RD
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21209-1410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-318-8713
-----------------------------------------------------
Fax | 443-870-4919
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2702 GEARTNER RD
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21209-1410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-318-8713
-----------------------------------------------------
Fax | 443-870-4919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R209667
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------