Provider Demographics
NPI:1508802331
Name:BADRO, DEBORAH L (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:BADRO
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:PO BOX 64042
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4042
Mailing Address - Country:US
Mailing Address - Phone:410-787-4830
Mailing Address - Fax:410-595-1933
Practice Address - Street 1:8601 VETERANS HWY
Practice Address - Street 2:STE 204
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1547
Practice Address - Country:US
Practice Address - Phone:410-729-0424
Practice Address - Fax:410-729-0492
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR104338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD42400500Medicaid
DCO242-0017OtherCARE FIRST BLUE CROSS
MD208212OtherJOHNS HOPKINS HEALTH CARE
MD68687203OtherCARE FIRST BLUE CROSS
MD6003OtherBRAVO/ELDER HEALTH
MD69913OtherAMERIGROUP
MD858052OtherNCPPO
MD208212OtherJOHNS HOPKINS HEALTH CARE