Individual
MR. ETHAN ANDREW HARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, SRNA
Contact information
Practice address
655 W LOMBARD ST, BALTIMORE, MD 21201-1512
(912) 230-3340
Mailing address
616 LIONS GATE LN, ODENTON, MD 21113-2421
(912) 230-3340
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R254935
MD
163WG0000X
General Practice Registered Nurse
RN500003248
DC
390200000X
Student in an Organized Health Care Education/Training Program
R254935
MD
390200000X
Student in an Organized Health Care Education/Training Program
RN500003248
DC
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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