Ivana Mitic, CRNA | |
909 Ridgebrook Rd Ste 202, Sparks, MD 21152-9476 | |
(410) 870-5482 | |
Not Available |
Full Name | Ivana Mitic |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 909 Ridgebrook Rd Ste 202, Sparks, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1962743815 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 784417 (Texas) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R212937 (Maryland) | Primary |
Entity Name | Baltimore Ketamine Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972145381 PECOS PAC ID: 9739568569 Enrollment ID: O20220624000152 |
Entity Name | Baltimore Ketamine Clinic Eastern Shore |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366171720 PECOS PAC ID: 2961881628 Enrollment ID: O20220627001766 |
Mailing Address | Practice Location Address |
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Ivana Mitic, CRNA 909 Ridgebrook Rd Ste 202, Sparks, MD 21152-9476 Ph: () - | Ivana Mitic, CRNA 909 Ridgebrook Rd Ste 202, Sparks, MD 21152-9476 Ph: (410) 870-5482 |
Marissa Surdy, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 909 Ridgebrook Rd Ste 300, Sparks, MD 21152 Phone: 443-383-9300 | |
Ms. Nina Sharma, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 909 Ridgebrook Rd Ste 300, Sparks, MD 21152 Phone: 443-383-9300 | |
Elizabeth Quince, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 909 Ridgebrook Rd Ste 220, Sparks, MD 21152 Phone: 443-383-9300 | |
Sara Osei-bonsu, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 909 Ridgebrook Rd Ste 300, Sparks, MD 21152 Phone: 443-383-9300 | |
Clementina Olusoga, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 909 Ridgebrook Rd Ste 300, Sparks, MD 21152 Phone: 301-377-8431 | |
Christopher J. Englert, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10 Fila Way, Ste. 205, Sparks, MD 21152 Phone: 410-472-1006 Fax: 410-472-0900 | |
Hsiu Chin Lin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 909 Ridgebrook Rd Ste 300, Sparks, MD 21152 Phone: 443-383-9300 |