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NPI Code Detail

MEDICARE: SUSAN C. MORDENTE RN

MEDICARE: SUSAN C. MORDENTE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WR0006XRegistered Nurse First AssistantR044128MD

General Provider Information

NPI Number : 1003002346
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN C. MORDENTE RN
Provider Business Mailing Address
First Line : 2007 ROCK SPRING RD
Second Line :
City : FOREST HILL
State : MD
Zip : 21050-2620
Country : US
Telephone Number : 410-879-2474
Fax Number :
Provider Business Practice Location Address
First Line : 2007 ROCK SPRING RD
Second Line :
City : FOREST HILL
State : MD
Zip : 21050-2620
Country : US
Telephone Number : 410-879-2474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2007
Last Update Date : 09/20/2007

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