Individual
SANDRA VANESSA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(443) 223-1046
Mailing address
533 W CENTRAL AVE, DAVIDSONVILLE, MD 21035-1942
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R191831
MD
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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