Individual
MARIA LOURDES EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-FAMILY
Contact information
Practice address
1576 MERRITT BLVD STE 18, DUNDALK, MD 21222-2132
(855) 527-7246
(866) 229-5063
Mailing address
5728 FIELDCREST DR, WHITE MARSH, MD 21162-1143
(410) 256-0373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R172336
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0804
—
MD
Enumeration date
01/30/2020
Last updated
11/30/2022
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