Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | R111182 | MD |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R111182 | MD |
NPI | 1265792139 |
---|---|
Provider Name | Anne Marie Weichold |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2012 |
Last Update Date | 09/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
339824200 | (05) | MD |
S062-0508 | CAREFIRST (01) | MD |