Provider Demographics
NPI:1003617580
Name:PEARSON, VIVIANA KATHERINE (NEONATAL NURSE PRACT)
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:KATHERINE
Last Name:PEARSON
Suffix:
Gender:
Credentials:NEONATAL NURSE PRACT
Other - Prefix:
Other - First Name:VIVIANA
Other - Middle Name:KATHERINE
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9086 FOX STREAM WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2556
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:443-297-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR263414163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care