Charles, Marie Fayette

Charles, Marie Fayette is an individual health care provider with primary practice located at 3261 Old Washington Rd Ste 2020 , Waldorf MD 20602-3231. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Charles, Marie Fayette can be contacted via phone (240) 419-2412.

Contact Information

Primary practice address
3261 Old Washington Rd Ste 2020 Waldorf MD 20602-3231
Phone: (240) 419-2412
Fax: (240) 366-5753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024180406 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R221196 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0024180406 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R221196 Maryland

Profile Details

NPI number 1376048348
LBN Legal business name Charles, Marie Fayette
Credentials CRNP-FNP-PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2018
Last updated Jan 10th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376048348 NPPES
Maryland MEDICAID 911012700
Maryland MEDICAID 601507691

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