WATCHEMSPROUT PEDIATRICS LLC NPI 1093000432

NPI Information

NPI: 1093000432
Provider Name: WATCHEMSPROUT PEDIATRICS LLC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 21D2029932

Address:
1190 W NORTHERN PKWY
SUITE 101
BALTIMORE, MD
ZIP 21210
Phone: (410) 433-0801
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WATCHEMSPROUT PEDIATRICS LLC is a pediatrics nurse practitioner in Baltimore, MD. WATCHEMSPROUT PEDIATRICS LLC NPI is 1093000432. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1190 W NORTHERN PKWY
SUITE 101
BALTIMORE, MD
ZIP 21210-431
Phone: (410) 433-0801

The provider's authorized official is Mary T Reus .
The authorized official title is Nurse Practitioner and has the following contact phone number (410) 433-0801.

The CLIA number assigned to this NPI record is 21D2029932 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2011 and was last updated on 6/14/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	R146510	MARYLAND	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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