Provider Demographics
NPI:1689338931
Name:ERRERA, AJA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AJA
Middle Name:
Last Name:ERRERA
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 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:125 SHOREWAY DR STE 120
Practice Address - Street 2:
Practice Address - City:QUEENSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21658-1681
Practice Address - Country:US
Practice Address - Phone:410-827-4001
Practice Address - Fax:410-827-4333
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty