Provider Demographics
NPI:1871507210
Name:RATHBAUER, MARGRETA MARY HELEN (CRNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGRETA
Middle Name:MARY HELEN
Last Name:RATHBAUER
Suffix:
Gender:F
Credentials:CRNP, PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 WELLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1432
Mailing Address - Country:US
Mailing Address - Phone:410-486-6263
Mailing Address - Fax:
Practice Address - Street 1:1001 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2516
Practice Address - Country:US
Practice Address - Phone:410-823-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR129781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD082NS222Medicare PIN
MD082NO441Medicare PIN
MD590LL816Medicare PIN
MDQ44075Medicare UPIN