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Individual

ANNIE KATHLEEN GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R201985
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R201985
LICENSE
MD
Enumeration date
08/05/2021
Last updated
10/11/2021
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