Provider Demographics
NPI:1477792604
Name:IRBY, IRENE GEK-HIA (NP)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:GEK-HIA
Last Name:IRBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64131
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4131
Mailing Address - Country:US
Mailing Address - Phone:410-571-7800
Mailing Address - Fax:410-471-0362
Practice Address - Street 1:108 FORBES ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1502
Practice Address - Country:US
Practice Address - Phone:410-571-7880
Practice Address - Fax:410-571-0362
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202633363LC0200X
MSR762005363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD544102100Medicaid
414911ZA38Medicare PIN