Provider Demographics
NPI:1306872148
Name:SILBERT-FLAGG, JOANNE (CRNP)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:SILBERT-FLAGG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 KNOLL NORTH DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2300
Mailing Address - Country:US
Mailing Address - Phone:410-964-6300
Mailing Address - Fax:410-964-2667
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2300
Practice Address - Country:US
Practice Address - Phone:410-964-6300
Practice Address - Fax:410-964-2667
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070053363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD006N853FMedicare ID - Type Unspecified
S56910Medicare UPIN