Provider Demographics
NPI:1760843627
Name:BEKKOURI, DENISE MARIE (CRNP-PEDIATRICS)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:BEKKOURI
Suffix:
Gender:F
Credentials:CRNP-PEDIATRICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:720 RUTLAND AVE # ROSS1125
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2109
Mailing Address - Country:US
Mailing Address - Phone:410-955-6132
Mailing Address - Fax:410-367-2748
Practice Address - Street 1:720 RUTLAND AVE
Practice Address - Street 2:JOHNS HOPKINS PEDIATRIC HEMATOLOGY, ROSS 1125
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2109
Practice Address - Country:US
Practice Address - Phone:410-955-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185621363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics