MEDICARE: MS. GLORIA LINSALATA NURSE PRACTITIONER

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	363LP2300X	Primary Care Nurse Practitioner	R080091	MD

General Provider Information

NPI Number	:	1255568390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLORIA LINSALATA NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	115 SALLITT DR STE A
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2156
Country	:	US
Telephone Number	:	410-643-8000
Fax Number	:	410-643-8006

Provider Business Practice Location Address
First Line	:	115 SALLITT DR STE A
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2156
Country	:	US
Telephone Number	:	410-643-8000
Fax Number	:	410-643-8006

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

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	06/27/2023

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