Individual
MRS. ELAINE MARIE PETRUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6 RIGGS AVE, SEVERNA PARK, MD 21146-3814
(410) 222-6577
(410) 222-6522
Mailing address
1624 ANGUS CT, CROFTON, MD 21114-2002
(410) 451-5932
(410) 222-6522
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP34135
MD
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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