Individual provider · Type 1 NPI
Carmen Susanne Licavoli, MSN, APRN-BC
Adult Health Nurse Practitioner · Baltimore, MD
NPI number
1538199534
Active
Practice location
10 N Greene St
Baltimore, MD 21201-1524
Mailing address
603 Captain John Brice Way
Annapolis, MD 21401-6327
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704185653 (MI) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | R189866 (MD) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1538199534
Carmen Susanne Licavoli, MSN, APRN-BC's National Provider Identifier is 1538199534, issued on Jul 4, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Baltimore, MD. The record was last updated on Oct 2, 2012.