Santo Domingo, Lisa Linn

Santo Domingo, Lisa Linn is an individual health care provider with primary practice located at 600 N Wolfe St Brady 320, Baltimore MD 21287-0005. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Santo Domingo, Lisa Linn can be contacted via phone (410) 955-8769.

Contact Information

Primary practice address
600 N Wolfe St Brady 320 Baltimore MD 21287-0005
Phone: (410) 955-8769
Fax: (410) 955-1464
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R175012 Maryland

Profile Details

NPI number 1992970552
LBN Legal business name Santo Domingo, Lisa Linn
Credentials CRNP-PEDIATRICS
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2008
Last updated Aug 10th, 2012 - about 12 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 1992970552 NPPES
Maryland MEDICAID 027626000

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