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Individual

MEREDITH C LIZMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6701 N CHARLES ST STE 3105, BALTIMORE, MD 21204-6808
(443) 849-2600
(443) 849-2620
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R152870
MD
363LA2200X
Adult Health Nurse Practitioner
R152870
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
403735900
MD
01
KJ31/621909-03
CAREFIRST MD-GBMC
MD
01
KT93ST / 621909-01
BC / BS OF MD
MD
01
S131/0004
CAREFIRST REGIONAL-GBMC
MD
01
S186 / 0066
BLUECHOICE
MD
Enumeration date
06/03/2006
Last updated
11/16/2009
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