Provider Demographics
NPI:1417190505
Name:GOLDSTONE, ELLEN F (CRNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:F
Last Name:GOLDSTONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:S
Other - Last Name:EISENSTADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:13801 YORK RD
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1825
Mailing Address - Country:US
Mailing Address - Phone:443-578-8077
Mailing Address - Fax:443-578-8199
Practice Address - Street 1:13801 YORK RD
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-1825
Practice Address - Country:US
Practice Address - Phone:443-578-8077
Practice Address - Fax:443-578-8199
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR076741364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD224166Medicare PIN