Provider Demographics
NPI:1528085107
Name:MARSDEN, REBECCA F (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:F
Last Name:MARSDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220B E JOPPA RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5813
Mailing Address - Country:US
Mailing Address - Phone:410-494-1888
Mailing Address - Fax:410-494-1008
Practice Address - Street 1:1220B E JOPPA RD
Practice Address - Street 2:SUITE 310
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-5813
Practice Address - Country:US
Practice Address - Phone:410-494-1888
Practice Address - Fax:410-494-1008
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR130562363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407780600Medicaid
MD262ML502Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MDQ46480Medicare UPIN