Basic Information
| Provider Information | |||||||||
| NPI: | 1639817976 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOSENFELD | ||||||||
| FirstName: | STACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 S GREENE ST # S10B00 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103285840 | ||||||||
| FaxNumber: | 4103280717 | ||||||||
| Practice Location | |||||||||
| Address1: | 419 W REDWOOD ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212017003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141416 | ||||||||
| FaxNumber: | 4103285147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2022 | ||||||||
| LastUpdateDate: | 11/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | R216733 | MD | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LA2100X | R216733 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.