1427142553 NPI number — MRS. SARA CATHERINE ADELMAN CRNP

Table of content: MRS. SARA CATHERINE ADELMAN CRNP (NPI 1427142553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427142553 NPI number — MRS. SARA CATHERINE ADELMAN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADELMAN
Provider First Name:
SARA
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427142553
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
116 DEFENSE HWY
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-7027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-897-9841
Provider Business Mailing Address Fax Number:
410-897-9852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
277 PENINSULA FARM RD STE I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARNOLD
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21012-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-989-8833
Provider Business Practice Location Address Fax Number:
410-975-5641
Provider Enumeration Date:
10/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  R158779 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)