Provider Demographics
NPI:1396583159
Name:GUTOWSKI, HALEY FREILINO (DNP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:FREILINO
Last Name:GUTOWSKI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:THOMPSON
Other - Last Name:FREILINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1117 S BOULDIN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5002
Mailing Address - Country:US
Mailing Address - Phone:412-715-5754
Mailing Address - Fax:
Practice Address - Street 1:11121 YORK RD
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-2006
Practice Address - Country:US
Practice Address - Phone:410-628-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR238978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily