Provider Demographics
NPI:1760525950
Name:RAPPAPORT, SONDRA (CRNP)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:RAPPAPORT
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 1:1838 GREENE TREE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-653-0366
Mailing Address - Fax:410-653-2527
Practice Address - Street 1:1838 GREENE TREE RD
Practice Address - Street 2:STE 300
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-653-0366
Practice Address - Fax:410-653-2527
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR086758363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
520283Medicare UPIN
592MG658Medicare ID - Type Unspecified