Individual
BRENDA KAY MATHEWS-VITELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
116 DEFENSE HWY, SUITE 400, ANNAPOLIS, MD 21401-7027
(410) 897-9841
(410) 897-9852
Mailing address
116 DEFENSE HWY, SUITE 400, ANNAPOLIS, MD 21401-7027
(410) 897-9841
(410) 897-9852
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R154292
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R154292
STATE LICENSE
MD
Enumeration date
02/11/2008
Last updated
06/27/2013
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