Provider Demographics
NPI:1295109809
Name:WEINRUB, ABBY TAYLOR (CRNP)
Entity type:Individual
Prefix:MS
First Name:ABBY
Middle Name:TAYLOR
Last Name:WEINRUB
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:TAYLOR
Other - Last Name:PROUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3499 CLOVER MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2346
Mailing Address - Country:US
Mailing Address - Phone:443-307-3232
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1590
Practice Address - Country:US
Practice Address - Phone:410-328-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015592363LA2200X, 363LG0600X
MDR187154363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA470392FLTMedicare PIN