Individual
SUSAN K CARLYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9000 FRANKLIN SQUARE DR, BALTIMORE, MD 21237-3901
(449) 777-7179
Mailing address
1136 OLDFIELD POINT RD, ELKTON, MD 21921-7234
(443) 907-3090
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
L6-0A00515
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
R134290
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52-1969010
TAX ID
MD
05
—
522PS452
—
MD
Enumeration date
01/05/2007
Last updated
10/03/2023
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