Individual
MISS SARA ELIZABETH ATWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
600 N WOLFE ST, BLALOCK 935, BALTIMORE, MD 21287-0005
(410) 614-6222
Mailing address
600 N WOLFE ST, BLALOCK 935, BALTIMORE, MD 21287-0005
(410) 614-6222
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R160179
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
R 160179
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026705800
—
MD
Enumeration date
06/30/2009
Last updated
11/20/2009
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