Individual
MRS. ELIZABETH HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-1981
(410) 328-6956
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-1981
(410) 328-6956
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R179749
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100014400
—
MD
01
—
S062-0539
CAREFIRST BC/BS
MD
Enumeration date
04/09/2014
Last updated
02/06/2015
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