Active NPI
Carolina Delacruz, DNP, CRNP, FNP-BC
- Gerontology Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1578114229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- R157663
- Practice address
- 5601 Loch Raven Blvd BLDG Center
Baltimore, MD 21239-2945 - Phone
- (443) 444-4720
- NPI assigned
- Sep 24, 2019
- Last updated
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R157663 | MD | Primary |
Addresses
Primary practice location
5601 Loch Raven Blvd BLDG Center
Baltimore, MD 21239-2945
Mailing address
205 NE Isle Dr
North East, MD 21901-3112
Phone (443) 876-2338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R157663 | MD | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1578114229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 NE ISLE DR",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219013112",
"telephone_number": "443-876-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 LOCH RAVEN BLVD BLDG CENTER",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212392945",
"telephone_number": "443-444-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELACRUZ",
"first_name": "CAROLINA",
"credential": "DNP, CRNP, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-24",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MD",
"license": "R157663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.