Provider Demographics
NPI:1306121538
Name:RUNDE, CARRIE ANNE (ND)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:RUNDE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 ROLAND AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:443-835-1268
Mailing Address - Fax:844-654-7169
Practice Address - Street 1:4800 ROLAND AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:443-835-1268
Practice Address - Fax:844-654-7169
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP-0026175F00000X
MDJ0000010175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath