Provider Demographics
NPI:1518959261
Name:ROSS, CLARE A (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:A
Last Name:ROSS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2917
Mailing Address - Country:US
Mailing Address - Phone:410-684-2031
Mailing Address - Fax:
Practice Address - Street 1:125 SHOREWAY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:QUEENSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21658-1666
Practice Address - Country:US
Practice Address - Phone:410-827-4001
Practice Address - Fax:410-827-4333
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR103591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD120189OtherJHHC PROVIDER NUMBER
MD500006562OtherRR MEDICARE
MD897100500Medicaid
MD546511-03OtherCAREFIRST MD RENDERING
MD7605-0034OtherCAREFIRST BLUECHOICE
MD9727222OtherAETNA PPO
MD1985372OtherAETNA HMO
S71330Medicare UPIN
MD897100500Medicaid