CRISFIELD CLINIC, LLC (NPI# 1962768655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962768655 |
| Entity Type | Organization |
| Organization Name | CRISFIELD CLINIC, LLC |
| Practice Address |
6062 Bridle Ct Salisbury MD 21801-1715 |
| Mailing Address |
4384 Crisfield Hwy Crisfield MD 21817-2550 |
| Practice Telephone | 4434930062 |
| Mailing Telephone | 4434930062 |
| Mailing Fax Number | 4437820076 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |
| Authorized Official Name | DR. KERRY COLLEEN PALAKANIS (OWNER) |
| Authorized Official Telephone | 4434930062 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R105366 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CRISFIELD CLINIC, LLC | 4384 Crisfield Hwy, Crisfield, MD 21817-2550 |
| Street Address |
6062 BRIDLE CT |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-1715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871874198 | Affinity Services LLC | Nurse Practitioner | 6062 Bridle Ct, Salisbury, MD 21801-1715 | 2011-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
| 1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
| 1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
| 1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
| 1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
| 1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
| 1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
| Find all providers in zip 21801 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891347761 | Craig Mullen | Nurse Practitioner | 436 Rolling Rd, Salisbury, MD 21801-7115 | 2019-07-11 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1205496452 | Priscilla Afram Debrah | Nurse Practitioner | 106 Milford St Ste 503, Salisbury, MD 21804-6958 | 2019-06-19 |
| 1801375498 | Jennifer Hart | Nurse Practitioner | 1101 Camden Ave # Dh240, Salisbury, MD 21801-6860 | 2018-08-14 |
| 1073006862 | Jonathan Andrews | Nurse Practitioner | 1201 Pemberton Dr Ste 2a, Salisbury, MD 21801-2501 | 2018-06-07 |
| 1174050447 | Melody Jean Evans | Nurse Practitioner | 145 E Carroll St Ste 101102, Salisbury, MD 21801 | 2017-05-17 |
| 1710380621 | Traci Ann Church | Nurse Practitioner | 1325 Mount Hermon Rd Ste 9a, Salisbury, MD 21804 | 2014-10-06 |
| 1891124608 | Lauren Moore | Nurse Practitioner | 100 E Carroll St Ste 301&406, Salisbury, MD 21801-5422 | 2013-11-02 |
| 1033465166 | Patricia Maria Morales | Nurse Practitioner | 5584 King Stuart Dr, Salisbury, MD 21801-2358 | 2012-07-26 |
| 1871874198 | Affinity Services LLC | Nurse Practitioner | 6062 Bridle Ct, Salisbury, MD 21801-1715 | 2011-08-31 |
| Find all providers in SALISBURY | ||||
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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.