Provider Demographics
NPI:1902285281
Name:PARAYIL, SIBI KURIAKOSE (CRNP)
Entity Type:Individual
Prefix:
First Name:SIBI
Middle Name:KURIAKOSE
Last Name:PARAYIL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:PARAYIL
Other - Middle Name:KURIAKOSE
Other - Last Name:SIBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:10279 GLOBE DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2111
Mailing Address - Country:US
Mailing Address - Phone:410-461-5655
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR175329363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care