MEDICARE: ERNESTINA DEL ROSARIO ATKINS FNP-BC

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	363LF0000X	Family Nurse Practitioner	R207948	MD

General Provider Information

NPI Number	:	1801371703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERNESTINA DEL ROSARIO ATKINS FNP-BC

Provider Business Mailing Address
First Line	:	13110 SOUNDINGS RD
Second Line	:
City	:	LUSBY
State	:	MD
Zip	:	20657-2662
Country	:	US
Telephone Number	:	352-256-0664
Fax Number	:

Provider Business Practice Location Address
First Line	:	8924 CHESAPEAKE AVE
Second Line	:
City	:	NORTH BEACH
State	:	MD
Zip	:	20714-4050
Country	:	US
Telephone Number	:	410-257-7279
Fax Number	:

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

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	10/01/2021

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