Provider Demographics
NPI:1205388667
Name:NORTEY, EMMANUELLA (CRNP)
Entity Type:Individual
Prefix:
First Name:EMMANUELLA
Middle Name:
Last Name:NORTEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4260
Mailing Address - Country:US
Mailing Address - Phone:443-571-3585
Mailing Address - Fax:410-576-0872
Practice Address - Street 1:7533 BETTYS WAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2075
Practice Address - Country:US
Practice Address - Phone:443-326-9885
Practice Address - Fax:443-272-7048
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR177818363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner