Provider Demographics
NPI:1932644457
Name:SAGAL, MEREDITH FAE (CRNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:FAE
Last Name:SAGAL
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 1:10153 YORK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3398
Mailing Address - Country:US
Mailing Address - Phone:410-472-1006
Mailing Address - Fax:410-472-0900
Practice Address - Street 1:10153 YORK RD STE 104
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-3398
Practice Address - Country:US
Practice Address - Phone:410-472-1006
Practice Address - Fax:410-472-0900
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR195908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily