Provider Demographics
NPI: | 1952379604 |
---|---|
Name: | BITNER, MARIANNE F (CRNA) |
Entity type: | Individual |
Prefix: | |
First Name: | MARIANNE |
Middle Name: | F |
Last Name: | BITNER |
Suffix: | |
Gender: | F |
Credentials: | CRNA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 775 CRAIGTOWN RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PORT DEPOSIT |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21904-1827 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-404-5000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 100 WEST RD |
Practice Address - Street 2: | |
Practice Address - City: | TOWSON |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21204-2331 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-698-6432 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-03-09 |
Last Update Date: | 2023-06-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | R070948 | 367500000X, 363LP0808X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MD | 858MM954 | Medicare ID - Type Unspecified |