Individual
BRENDA L VITUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
14303 LAKE ROYER DR, CASCADE, MD 21719-1602
(240) 852-0694
Mailing address
14303 LAKE ROYER DR, CASCADE, MD 21719-1602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R081680
MD
363LF0000X
Family Nurse Practitioner
SP015218
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103040951
—
PA
Enumeration date
09/07/2006
Last updated
08/30/2023
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