Individual
TATIANA G SMIRNOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
25 CROSSROADS DR, SUITE 205, OWINGS MILLS, MD 21117-5421
(410) 602-7792
(410) 602-9889
Mailing address
1589 SULPHUR SPRING RD, SUITE 109, BALTIMORE, MD 21227-2542
(410) 536-5400
(410) 737-2168
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R168730
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4098102 00
—
MD
Enumeration date
01/31/2006
Last updated
09/16/2011
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