Marilyn C Hernandez, CRNP
Individual provider Active NPI Family Nurse Practitioner · White Marsh, MD
NPI 1730669771 · NPPES record last updated Aug 20, 2018
Key facts
- NPI
- 1730669771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R171573 (MD)
- Practice address
- 5700 Fieldcrest Dr
White Marsh, MD 21162-1143 - Phone
- (410) 497-0990
- NPI assigned
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529000188 | MD | Practitioner - Nurse Practitioner | 5193146173 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current |
Accepting new patients | |
| Medstar Medical Group II LLC | Current |
Accepting new patients |
Locations
12 Medstar Blvd
Ste 265
Bel Air, MD 21015
Phone (301) 540-5246
12 Medstar Blvd
Bel Air, MD 21015
Phone (410) 877-8087
1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R171573 | MD | Yes |
Addresses
Primary practice location
5700 Fieldcrest Dr
White Marsh, MD 21162-1143
Mailing address
5700 Fieldcrest Dr
White Marsh, MD 21162-1143
Phone (410) 497-0990
Other providers in White Marsh, MD
- Taylor Garrett
- Gober Chiropractic Centers Inc
- Timothy Gober
- Taylor Green
- Richard Gross
- Justin Michael Higgins
- Jason Holmes
- Joseph M Hubicki
- Ideal Health Chiropractic, LLC
- Interventional Pain Institute Laboratory
All providers in White Marsh, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.