Provider Demographics
NPI:1699228544
Name:DONATELLI, ELISE (NP)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:DONATELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:KARWOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1200 S CONKLING ST
Mailing Address - Street 2:APT 403
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5222
Mailing Address - Country:US
Mailing Address - Phone:631-807-6851
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY586347163W00000X
MDR223523163W00000X, 363LA2100X
NY430940363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse