Provider Demographics
NPI:1669441093
Name:NARU, ANNETTE MARIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:NARU
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:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-0837
Mailing Address - Country:US
Mailing Address - Phone:301-997-1788
Mailing Address - Fax:301-997-1791
Practice Address - Street 1:41680 MISS BESSIE DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650
Practice Address - Country:US
Practice Address - Phone:301-997-1788
Practice Address - Fax:301-997-1791
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134286363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD606060900Medicaid
MD488M733FMedicare ID - Type Unspecified
MD606060900Medicaid