Provider Demographics
NPI:1811037559
Name:BAINS, ANITA LOUISE (MS RN CSP)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:LOUISE
Last Name:BAINS
Suffix:
Gender:F
Credentials:MS RN CSP
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Mailing Address - Street 1:1760 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6116
Mailing Address - Country:US
Mailing Address - Phone:410-302-5446
Mailing Address - Fax:
Practice Address - Street 1:5700 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-224-1711
Practice Address - Fax:302-513-9967
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2018-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR092697364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1811037559OtherBLUE CROSS BLUE SHIELD