Provider Demographics
NPI:1023002623
Name:HARE, JOAN MARIE (MSN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:HARE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:REITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:1307 STREAMVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5026
Mailing Address - Country:US
Mailing Address - Phone:410-838-1422
Mailing Address - Fax:
Practice Address - Street 1:580 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4310
Practice Address - Country:US
Practice Address - Phone:410-375-4136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN347349L363LF0000X
MDR133447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily