Individual
PHYLLIS CVACH SHAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
1645 LIBERTY RD, SUITE 204, ELDERSBURG, MD 21784-6521
(410) 795-7737
(410) 795-2828
Mailing address
7001 HOLLENBERRY RD, SYKESVILLE, MD 21784-7606
(410) 795-7529
(410) 795-2828
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R041230
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23951400
—
MD
05
—
277541700
—
MD
Enumeration date
07/03/2005
Last updated
01/06/2010
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