AUDREY FORKA (NPI# 1780087213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780087213 |
| Entity Type | Individual |
| Full Name | AUDREY FORKA |
| Credential | MSN,PMHNP-BC |
| Practice Address |
501 S Union Ave Behavioral Health Unit Havre De Grace MD 21078-3409 |
| Practice Telephone | 4448438050 |
| Practice Fax Number | 4438436088 |
| Mailing Telephone | 6095982298 |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2016-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AC001470 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
501 S UNION AVE BEHAVIORAL HEALTH UNIT |
| City | HAVRE DE GRACE |
| State | MD |
| Zip Code | 21078-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770589533 | Harford Memorial Hospital | General Acute Care Hospital | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2005-06-24 |
| 1588286520 | Antonio W Herold | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2020-05-13 |
| 1689199259 | Katharine Sewell | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2017-08-04 |
| 1013372705 | Constance Noll | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2015-12-22 |
| 1073991469 | Laura Nengel | Pharmacist | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2015-05-18 |
| 1679973382 | Brandon Phillips | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2014-08-29 |
| 1619230539 | Pamela J Llewellyn | Social Worker | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2012-06-18 |
| 1467734434 | David J Kitchen | Nurse Practitioner | 501 S Union Ave, Wound Care Clinic, Havre De Grace, MD 21078-3409 | 2011-09-15 |
| 1114206620 | Sara Marie Hickey | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2011-08-15 |
| 1689861874 | Deborah Lee Simon | Pharmacist | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2007-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265076327 | Shannon Mona Lane | Social Worker | [email protected], 609 Peace Chance Dr., Havre De Grace, MD 21078 | 2019-11-01 |
| 1134699788 | Amanda Graziano | Speech-Language Pathologist | 201 Oakington Rd, Havre De Grace, MD 21078 | 2018-11-27 |
| 1689111551 | Barbara Rene-darbouze | Counselor | 400 Lewis Street, Havre De Grace, MD 21078 | 2017-01-30 |
| 1598136459 | Proud and Positive Treatment Services Inc. | Clinic/Center | 602 Revolution St., Suite 103, Havre De Grace, MD 21078 | 2015-10-16 |
| 1427426337 | Leodegario Ayson Najera Sr. | Surgery | 121 Flying Ebony Place, Havre De Grace, MD 21078 | 2015-09-09 |
| 1669857538 | Connie Dausch | Counselor | 100 St John Street, Suite 1, Havre De Grace, MD 21078 | 2015-07-21 |
| 1659777225 | Doris Stacy Fair | Counselor | 501 South Union Ave., Harford Memorial Hospital, Havre De Grace, MD 21078 | 2014-11-10 |
| 1871995860 | Faith Ku | Pharmacist | 1000 Pulaski Highway, Havre De Grace, MD 21078 | 2014-09-22 |
| 1376889121 | Lorien Life Center Harford II, Inc. | Skilled Nursing Facility | 1501 Blenheim Farm Lane, Havre De Grace, MD 21078 | 2012-12-26 |
| 1396000790 | Pdom Havre De Grace | Dentist | 2021 Pulaski Highway Units A and B, Havre De Grace, MD 21078 | 2012-07-11 |
| Find all providers in zip 21078 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286520 | Antonio W Herold | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2020-05-13 |
| 1689199259 | Katharine Sewell | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2017-08-04 |
| 1043768906 | Carla Dimiris | Nurse Practitioner | 400 Lewis St, Havre De Grace, MD 21078-3405 | 2016-09-20 |
| 1679973382 | Brandon Phillips | Nurse Practitioner | 501 S Union Ave, Havre De Grace, MD 21078-3409 | 2014-08-29 |
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| 1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
| 1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
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| Find all providers with the same taxonomy | ||||
| City | HAVRE DE GRACE |
| Zip Code | 21078 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.