Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | R115148 | MD |
NPI | 1346434206 |
---|---|
Provider Name | Mrs. Karen Aileen Stadd |
First Address | Baltimore, MD 21287-3200 |
Second Address | Baltimore, MD 21287-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 04/09/2007 |