Provider Demographics
NPI:1972210250
Name:FERNALD, MARIA (DNP, PMHNP-BCCPNP-PC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:FERNALD
Suffix:
Gender:
Credentials:DNP, PMHNP-BCCPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4967 BRISTLE CONE CIR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2605
Mailing Address - Country:US
Mailing Address - Phone:484-356-7349
Mailing Address - Fax:
Practice Address - Street 1:4967 BRISTLE CONE CIR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2605
Practice Address - Country:US
Practice Address - Phone:484-356-7349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR256672208000000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No208000000XAllopathic & Osteopathic PhysiciansPediatrics