Individual
AILEEN LARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2000 MEDICAL PKWY STE 304, ANNAPOLIS, MD 21401-3745
(105) 739-5304
(664) 204-7229
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R175578
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
772153600
—
MD
01
—
791003
MEDICARE
MD
01
—
792305
MEDICARE
MD
01
—
CY310018
BCBS
MD
Enumeration date
01/31/2019
Last updated
12/23/2024
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