Provider Demographics
NPI:1841760550
Name:YUDKOWSKY, SHOSHANA A (CRNP)
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:A
Last Name:YUDKOWSKY
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 1:2700 QUARRY LAKE DR STE 280
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3769
Mailing Address - Country:US
Mailing Address - Phone:410-469-5544
Mailing Address - Fax:410-585-2867
Practice Address - Street 1:2700 QUARRY LAKE DR STE 280
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3769
Practice Address - Country:US
Practice Address - Phone:410-469-5544
Practice Address - Fax:410-585-2867
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201550207RN0300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology