Individual
MRS. STEPHANIE M ENTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2401 W BELVEDERE AVE, DEPT OF PEDIATRICS, BALTIMORE, MD 21215-5216
(410) 601-8393
(410) 601-8390
Mailing address
2401 W BELVEDERE AVE, ATTN: CREDENTIALING, BALTIMORE, MD 21215-5216
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R096361
MD
2080P0207X
Pediatric Hematology & Oncology Physician
R096361
MD
363L00000X
Nurse Practitioner
Primary
R096361
MD
Other
Enumeration date
05/10/2006
Last updated
10/18/2007
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