Individual
CYNTHIA MARIE FAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
5230 CAMPBELL BOULEVARD, WHITE MARSH, MD 21236
(410) 550-0100
Mailing address
5230 CAMPBELL BOULEVARD, WHITE MARSH, MD 21236
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R153439
MD
363LF0000X
Family Nurse Practitioner
Primary
R153439
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010387000
—
MD
Enumeration date
06/22/2006
Last updated
01/21/2016
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