Provider Demographics
NPI:1699233288
Name:MOSCARELLA, LINA SAVAGE (NP)
Entity type:Individual
Prefix:MRS
First Name:LINA
Middle Name:SAVAGE
Last Name:MOSCARELLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LINA
Other - Middle Name:
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:10901 CONNECTICUT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1645
Mailing Address - Country:US
Mailing Address - Phone:240-290-1041
Mailing Address - Fax:240-669-3014
Practice Address - Street 1:10901 CONNECTICUT AVE STE 100
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1645
Practice Address - Country:US
Practice Address - Phone:240-290-1041
Practice Address - Fax:240-669-3014
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR131920163W00000X, 364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health