Provider Demographics
NPI:1659420586
Name:FLAHARTY, NADINE F (CRNM)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:F
Last Name:FLAHARTY
Suffix:
Gender:F
Credentials:CRNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15204 OMEGA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4814
Mailing Address - Country:US
Mailing Address - Phone:301-330-7002
Mailing Address - Fax:301-330-7006
Practice Address - Street 1:15204 OMEGA DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4814
Practice Address - Country:US
Practice Address - Phone:301-330-7002
Practice Address - Fax:301-330-7006
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR126791367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
R126791OtherMARYLAND LICENSE