Provider Demographics
NPI:1326692450
Name:RAMOS, ANDY JOHN MARCELO CAYTON (CRNP)
Entity Type:Individual
Prefix:MR
First Name:ANDY JOHN MARCELO
Middle Name:CAYTON
Last Name:RAMOS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:MR
Other - First Name:ANDY JOHN
Other - Middle Name:CAYTON
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:9407 GEORGIA BELLE DR
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8819
Mailing Address - Country:US
Mailing Address - Phone:410-256-9178
Mailing Address - Fax:
Practice Address - Street 1:4155 GLEN PARK RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-1019
Practice Address - Country:US
Practice Address - Phone:410-248-0661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD161121363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care