Provider Demographics
NPI:1801371703
Name:ATKINS, ERNESTINA DEL ROSARIO (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERNESTINA
Middle Name:DEL ROSARIO
Last Name:ATKINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13110 SOUNDINGS RD
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-2662
Mailing Address - Country:US
Mailing Address - Phone:352-256-0664
Mailing Address - Fax:
Practice Address - Street 1:8924 CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEACH
Practice Address - State:MD
Practice Address - Zip Code:20714-4050
Practice Address - Country:US
Practice Address - Phone:410-257-7279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily