MEDICARE: CELINE FOTIE

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R223546	MD

General Provider Information

NPI Number	:	1043072259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE FOTIE

Provider Business Mailing Address
First Line	:	1101 STOURHEAD CT
Second Line	:
City	:	ABINGDON
State	:	MD
Zip	:	21009-1075
Country	:	US
Telephone Number	:	443-469-4593
Fax Number	:	479-935-8316

Provider Business Practice Location Address
First Line	:	1101 STOURHEAD CT
Second Line	:
City	:	ABINGDON
State	:	MD
Zip	:	21009-1075
Country	:	US
Telephone Number	:	443-469-4593
Fax Number	:	479-935-8316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	05/19/2026

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Directions to “ CELINE FOTIE ” Practice Location

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