Provider Demographics
NPI:1619027877
Name:EHUDIN BEARD, EILEEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:EHUDIN BEARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:EHUDIN PAGANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:10420 GREENACRES DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1405
Mailing Address - Country:US
Mailing Address - Phone:443-506-0555
Mailing Address - Fax:
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 4105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-821-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO41532363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner