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Individual

EKATERINA VERSACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
4B NORTH AVE STE 302, BEL AIR, MD 21014-2304
(443) 819-3172
Mailing address
4B NORTH AVE STE 302, BEL AIR, MD 21014-2304
(443) 819-3172

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R209076
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R209076
BOARD OF NURSING STATE OF MD
MD
Enumeration date
05/21/2021
Last updated
05/21/2021
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