Provider Demographics
NPI:1669420170
Name:KROSNICK, TERESA ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ASHLEY
Last Name:KROSNICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOHNS HOPKINS HOSPITAL WILMER 600 N WOLFE ST
Mailing Address - Street 2:WILMER 340
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0001
Mailing Address - Country:US
Mailing Address - Phone:410-955-5730
Mailing Address - Fax:410-614-0316
Practice Address - Street 1:JOHNS HOPKINS HOSPITAL WILMER 600 N WOLFE ST
Practice Address - Street 2:WILMER 340
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-5730
Practice Address - Fax:410-614-0316
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001904363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical