Individual
MRS. MARLENA RACHEL WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4502 N CHARLES ST, BALTIMORE, MD 21210-2607
(410) 617-5055
(410) 617-2173
Mailing address
3425 FOSTER AVE, BALTIMORE, MD 21224-4106
(443) 708-4324
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R176974
MD
363LG0600X
Gerontology Nurse Practitioner
R176974
MD
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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