Provider Demographics
NPI:1730518812
Name:BERCHIE, MARILYN (CRNP-FNP)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:BERCHIE
Suffix:
Gender:F
Credentials:CRNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 MCDONOGH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5273
Mailing Address - Country:US
Mailing Address - Phone:443-693-7246
Mailing Address - Fax:866-902-5997
Practice Address - Street 1:826 WASHINGTON RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5750
Practice Address - Country:US
Practice Address - Phone:443-693-7246
Practice Address - Fax:866-605-3655
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily