Provider Demographics
NPI:1114416815
Name:ROYSTER, CIARA (BSN,RN)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:ROYSTER
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 REVERDY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3220
Mailing Address - Country:US
Mailing Address - Phone:443-986-8840
Mailing Address - Fax:
Practice Address - Street 1:201 BACK RIVER NECK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-3949
Practice Address - Country:US
Practice Address - Phone:410-887-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197028163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health