Provider Demographics
NPI:1669558227
Name:DUJORDAN, ELENA M (CRNP)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:M
Last Name:DUJORDAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:D
Other - Last Name:BAYLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:560 RIVERSIDE DR
Mailing Address - Street 2:SUITE A-204
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4700
Mailing Address - Country:US
Mailing Address - Phone:410-749-2922
Mailing Address - Fax:410-546-0894
Practice Address - Street 1:560 RIVERSIDE DR
Practice Address - Street 2:SUITE A-204
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4700
Practice Address - Country:US
Practice Address - Phone:410-749-2922
Practice Address - Fax:410-546-0894
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR152586363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR152586OtherSTATE LICENSE
MDQ37875Medicare UPIN
MDMD661LMedicare PIN