Individual provider · Type 1 NPI
Shannon K. Idzik, CRNP
Primary Care Nurse Practitioner · Baltimore, MD
NPI number
1467445924
Active
Practice location
655 W Lombard St, 345
Baltimore, MD 21201-1512
Fax (410) 706-0344
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | R131534 (MD) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1467445924
Shannon K. Idzik, CRNP's National Provider Identifier is 1467445924, issued on Aug 30, 2005. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Baltimore, MD. The record was last updated on Jan 10, 2011.