Provider Demographics
NPI:1477146835
Name:VENTURINI RHODERICK, TERI JEAN (CRNP)
Entity Type:Individual
Prefix:
First Name:TERI JEAN
Middle Name:
Last Name:VENTURINI RHODERICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TERI JEAN
Other - Middle Name:
Other - Last Name:RHODERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:6934 AVIATION BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2593
Mailing Address - Country:US
Mailing Address - Phone:410-760-3588
Mailing Address - Fax:410-760-3604
Practice Address - Street 1:6934 AVIATION BLVD STE F
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2593
Practice Address - Country:US
Practice Address - Phone:410-760-3588
Practice Address - Fax:410-760-3604
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR142981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily