Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R211477 | MD |
NPI | 1033737226 |
---|---|
Provider Name | Sara Bortner |
First Address | Baltimore, MD 21209-3650 |
Second Address | Baltimore, MD 21209-3650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2020 |
Last Update Date | 22/03/2021 |