Individual
CONSTANCE MARIA DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1562 OPOSSUMTOWN PIKE, FREDERICK, MD 21702-4920
(402) 566-3031
Mailing address
PO BOX 37086, BALTIMORE, MD 21297-3086
(240) 439-8812
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R119937
MD
Other
Enumeration date
07/03/2019
Last updated
10/27/2020
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