Provider Demographics
NPI:1265100986
Name:MORANTE, ENRIQUETA (CMT)
Entity type:Individual
Prefix:MRS
First Name:ENRIQUETA
Middle Name:
Last Name:MORANTE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:MS
Other - First Name:ENRIQUETA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:3515 KENYON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1816
Mailing Address - Country:US
Mailing Address - Phone:443-708-4543
Mailing Address - Fax:443-708-4555
Practice Address - Street 1:3515 KENYON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1816
Practice Address - Country:US
Practice Address - Phone:443-708-4543
Practice Address - Fax:443-708-4555
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMT0130949374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide