Provider Demographics
NPI:1992773642
Name:BAHN, MARY APRIL (CRNP)
Entity type:Individual
Prefix:MS
First Name:MARY APRIL
Middle Name:
Last Name:BAHN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:M. APRIL
Other - Middle Name:
Other - Last Name:BAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:201 DEFENSE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8943
Mailing Address - Country:US
Mailing Address - Phone:443-481-3354
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:8579 COMMERCE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7491
Practice Address - Country:US
Practice Address - Phone:410-819-0404
Practice Address - Fax:410-819-0751
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR044064363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD331906700Medicaid
MD532588ZDWSMedicare PIN