Provider Demographics
NPI:1649707340
Name:CEDENO, GHISLAINE (APRN)
Entity type:Individual
Prefix:
First Name:GHISLAINE
Middle Name:
Last Name:CEDENO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:1800 ORLEANS STREET BLOOMBERG 11377 PEDS
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-4405
Practice Address - Country:US
Practice Address - Phone:410-955-8751
Practice Address - Fax:410-955-0028
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR195992163WP0200X, 363LP0200X
PARN702012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner