Provider Demographics
NPI:1437393808
Name:LUPINOS, GERALD (RN CRNI)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:LUPINOS
Suffix:
Gender:M
Credentials:RN CRNI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 KINTOP RD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4218
Mailing Address - Country:US
Mailing Address - Phone:443-889-4070
Mailing Address - Fax:
Practice Address - Street 1:501 KINTOP RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4218
Practice Address - Country:US
Practice Address - Phone:443-889-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR121027163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy