Provider Demographics
NPI:1508011354
Name:HARBERT, AMANDA C (CRNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:C
Last Name:HARBERT
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 1:193 STONER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5588
Mailing Address - Country:US
Mailing Address - Phone:410-871-2204
Mailing Address - Fax:410-871-2207
Practice Address - Street 1:193 STONER AVE STE 300
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5588
Practice Address - Country:US
Practice Address - Phone:410-871-2204
Practice Address - Fax:410-871-2207
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274132363LA2100X
MDR230071363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care