Basic Information
| Provider Information | |||||||||
| NPI: | 1093767352 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORTHRUP | ||||||||
| FirstName: | GRACE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7402 YORK RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212047532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108217471 | ||||||||
| FaxNumber: | 4108219582 | ||||||||
| Practice Location | |||||||||
| Address1: | SAINT JOSEPH MEDICAL CENTER | ||||||||
| Address2: | 7601 OSLER DRIVE | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103371226 | ||||||||
| FaxNumber: | 4103371118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R129200 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.