Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | R165735 | MD |
NPI | 1073850756 |
---|---|
Provider Name | Mrs. Karen Brownlie Difilippo |
First Address | Baltimore, MD 21287-0010 |
Second Address | Baltimore, MD 21287-0010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2013 |
Last Update Date | 29/01/2019 |