Provider Demographics
NPI:1578863312
Name:KRUPITSKAYA, ELLA I (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:I
Last Name:KRUPITSKAYA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 OLD COURT RD STE 204
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5126
Mailing Address - Country:US
Mailing Address - Phone:410-521-4211
Mailing Address - Fax:410-521-0627
Practice Address - Street 1:5400 OLD COURT RD STE 204
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5126
Practice Address - Country:US
Practice Address - Phone:410-521-4211
Practice Address - Fax:410-521-0627
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR 173481363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology