MEDICARE: BERNADETTE R GRECO 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	363L00000X	Nurse Practitioner	R127817	MD

General Provider Information

NPI Number	:	1215918362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNADETTE R GRECO CRNP

Provider Business Mailing Address
First Line	:	10200 GRAND CENTRAL AVE STE 220
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7580 BUCKINGHAM BLVD STE 110
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-3208
Country	:	US
Telephone Number	:	410-760-9400
Fax Number	:

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/12/2025

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