Individual
SUSAN OTREMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6196
Mailing address
6201 GREENLEIGH AVE FL 2, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R133788
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
R133788
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419030100
—
MD
01
—
960533-01
BLUE CROSS/BLUE SHIELD
MD
01
—
S062-0374
BLUE CROSS REGIONAL
MD
Enumeration date
05/23/2007
Last updated
08/28/2024
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