Provider Demographics
NPI:1790097913
Name:DUARTE, ANA C (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:C
Last Name:DUARTE
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 DRY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4340
Mailing Address - Country:US
Mailing Address - Phone:443-768-3052
Mailing Address - Fax:
Practice Address - Street 1:8840 STANFORD BLVD STE 1600
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5909
Practice Address - Country:US
Practice Address - Phone:240-512-0141
Practice Address - Fax:240-512-0151
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173665363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health