Provider Demographics
NPI:1699766527
Name:MORSE, MARY E (CRNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MORSE
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 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:DEPT. OF CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:LEVINDALE HEBREW GERIATRIC CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5202
Practice Address - Country:US
Practice Address - Phone:419-601-2246
Practice Address - Fax:410-601-2924
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070440363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD075002600Medicaid
MDN44351OtherCONTROLLED PRESCRIPTION #
MDR070440OtherNP LICENSE NUMBER
MM0308963OtherDEA NUMBER
MDH33030LLMedicare PIN
MDS99233Medicare UPIN
MDN44351OtherCONTROLLED PRESCRIPTION #