MEDICARE: MS. ELIZABETH KOLAR CRNP

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	363LA2200X	Adult Health Nurse Practitioner	RO36375	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G8920004	OTHER	MD	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1144340779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH KOLAR CRNP

Provider Business Mailing Address
First Line	:	UHS UMBC
Second Line	:	1000 HILLTOP CIRCLE
City	:	BALTIMORE
State	:	MD
Zip	:	21250-0001
Country	:	US
Telephone Number	:	410-455-1555
Fax Number	:	410-455-1125

Provider Business Practice Location Address
First Line	:	UHS UMBC
Second Line	:	1000 HILLTOP CIRCLE
City	:	BALTIMORE
State	:	MD
Zip	:	21250-0001
Country	:	US
Telephone Number	:	410-455-1555
Fax Number	:	410-455-1125

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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