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NPI Code Detail

MEDICARE: DR. DEBRA ANNE SCRANDIS PHD, CRNP-PMH

MEDICARE: DR. DEBRA ANNE SCRANDIS PHD, CRNP-PMH
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
1363LF0000XFamily Nurse PractitionerR151601MD
2363LP0808XPsychiatric/Mental Health Nurse PractitionerR151601MD

General Provider Information

NPI Number : 1740623800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA ANNE SCRANDIS PHD, CRNP-PMH
Provider Business Mailing Address
First Line : 114 S WASHINGTON ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21231-1937
Country : US
Telephone Number : 410-255-1400
Fax Number :
Provider Business Practice Location Address
First Line : 114 S WASHINGTON ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21231-1937
Country : US
Telephone Number : 410-255-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2013
Last Update Date : 05/08/2017

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