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Individual

MRS. GINA L. NOVAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
409 N CAROLINE ST, BALTIMORE, MD 21231-1003
(410) 614-6189
(410) 955-0729
Mailing address
409 N CAROLINE ST, BALTIMORE, MD 21231-1003
(410) 614-6189
(410) 955-0729

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RO91467
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
027536100
MD
01
RO91467
LICENSE
MD
Enumeration date
02/08/2007
Last updated
02/01/2010
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