Provider Demographics
NPI:1124742804
Name:BABICH, MARINELA (DNP, CPNP-PC)
Entity type:Individual
Prefix:
First Name:MARINELA
Middle Name:
Last Name:BABICH
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:NELLA
Other - Middle Name:
Other - Last Name:BABICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, CPNP-PC
Mailing Address - Street 1:5429 LUCKPENNY PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2331
Mailing Address - Country:US
Mailing Address - Phone:240-821-2823
Mailing Address - Fax:
Practice Address - Street 1:200 FORBES ST STE 200
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1599
Practice Address - Country:US
Practice Address - Phone:410-263-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204521363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics