Provider Demographics
NPI:1629105135
Name:LONGO-SCHOEBERLEIN, DENISE (CRNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:LONGO-SCHOEBERLEIN
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 1:601 N CAROLINE ST
Mailing Address - Street 2:4TH FLOOR ROOM 4150
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0006
Mailing Address - Country:US
Mailing Address - Phone:410-614-2587
Mailing Address - Fax:443-287-0108
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:4TH FLOOR ROOM 4150
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0006
Practice Address - Country:US
Practice Address - Phone:410-614-2587
Practice Address - Fax:443-287-0108
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR086829363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health