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NPI Code Detail

MEDICARE: ELAINE MARIE CRAIN CRNP

MEDICARE: ELAINE MARIE CRAIN 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
1363LA2200XAdult Health Nurse PractitionerR124009MD
2363LF0000XFamily Nurse PractitionerR124009MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F240 0003OTHERDCBLUE CROSS BLUE SHIELD
261911702OTHERMDBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1649385444
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINE MARIE CRAIN CRNP
Provider Business Mailing Address
First Line : 31 ROBINSON RD
Second Line :
City : SEVERNA PARK
State : MD
Zip : 21146-2841
Country : US
Telephone Number : 410-544-5900
Fax Number : 410-544-5939
Provider Business Practice Location Address
First Line : 31 ROBINSON RD
Second Line :
City : SEVERNA PARK
State : MD
Zip : 21146-2841
Country : US
Telephone Number : 410-544-5900
Fax Number : 410-544-5939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 09/12/2007

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Directions to “ ELAINE MARIE CRAIN CRNP” Practice Location

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