Provider Demographics
NPI:1417563891
Name:WAWRYSZYN, BARBARA KATARZYNA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:KATARZYNA
Last Name:WAWRYSZYN
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 1:12 BROOK FARM CT UNIT E
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9042
Mailing Address - Country:US
Mailing Address - Phone:443-946-7010
Mailing Address - Fax:
Practice Address - Street 1:12 BROOK FARM CT UNIT E
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9042
Practice Address - Country:US
Practice Address - Phone:443-946-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR193186363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health