MRS. LISA LINN SANTO DOMINGO CRNP-PEDIATRICS NPI 1992970552

NPI Information

NPI: 1992970552
Provider Name: MRS. LISA LINN SANTO DOMINGO, CRNP-PEDIATRICS
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
600 N WOLFE ST
BRADY 320
BALTIMORE, MD
ZIP 21287
Phone: (410) 955-8769
Get Directions

MRS. Lisa Linn Santo Domingo, CRNP-PEDIATRICS is a pediatrics nurse practitioner in Baltimore, MD. MRS. Lisa Linn Santo Domingo, CRNP-PEDIATRICS NPI is 1992970552. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

600 N WOLFE ST
BRADY 320
BALTIMORE, MD
ZIP 21287-005
Phone: (410) 955-8769
Fax: (410) 955-1464

The enumeration date for this NPI number is 4/24/2008 and was last updated on 8/10/2012.

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	R175012	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	169370ZAK7	MEDICARE PIN	MARYLAND
2	027626000	MEDICAID	MARYLAND

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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