1013247717 NPI number — ALEXANDRA TALBOTT MORREL CRNP-F

Table of content: DR. BAXTER CLAY HOLLAND M.D. (NPI 1922323781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013247717 NPI number — ALEXANDRA TALBOTT MORREL CRNP-F

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORREL
Provider First Name:
ALEXANDRA
Provider Middle Name:
TALBOTT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP-F
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TALBOTT
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
SPENCER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013247717
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3003 N CHARLES ST
Provider Second Line Business Mailing Address:
N200
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21218-3855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-516-6190
Provider Business Mailing Address Fax Number:
410-516-4784

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3003 N CHARLES ST
Provider Second Line Business Practice Location Address:
N200
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-3855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-516-6190
Provider Business Practice Location Address Fax Number:
410-516-4784
Provider Enumeration Date:
01/04/2010

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: 363LF0000X , with the licence number:  R161592 , 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)





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