Individual
AUDREY FORKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,PMHNP-BC
Contact information
Practice address
611 S UNION AVE, HAVRE DE GRACE, MD 21078-3421
(443) 526-6133
(443) 526-6134
Mailing address
501 S UNION AVE, BEHAVIORAL HEALTH UNIT, HAVRE DE GRACE, MD 21078-3409
(609) 598-2298
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AC001470
MD
Other
Enumeration date
09/29/2014
Last updated
10/12/2022
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