state of maryland · = new attestation . n a = new attestation w/addendum sheet. a = existing...
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STATE OF MARYLAND
O: Maryland Board of Nursing
NP, RN, FRE
f Nursing
DATE: September 25, 2012
E: Nurse Practitioner Attestation Approval
MARYLAND BOARD OF NURSING
BALT 2254
(410) 585-1900 10) 358-3530 FAX (410 ON
4140 PATTERSON AVENUE IMORE, MARYLAND 21215-
(4
) 585-1978 AUTOMATED VERIFICATI1-888-202-9861 TOLL FREE
1c M E M O R A N D U M
T FROM: Emmaline Woodson, D
Deputy Director Maryland Board o
R
he Advanced Practice Department at the Maryland Board of Nursing recommends the following
P NAME CERT. TYPE* COLLABORATOR(S) SITE
TNurse Practitioner Attestations and Attestation Addendums for approval: N
Abate, Thom Beth Abate, Nu ctitioner, Betelehem R166533
A N as Masterson, D50534 rse PraLLC
Abumere, Christy Inuata F N Ejemeh Okojie, D53685 , MD R122356
Ejemeh Okojie
Adelman, Sara A N Howard Goldstein, D26743 Annapolis Internal Medicine R158779 Akinlolu, Olayinka F N Jamal Fadul, D53745 Med-Ped Health Care, LLC Josephine R136194 Akintan, Oyesola F N A Anurita Mendhiratta, D38262; Gul Adventist Behavioral health Omowunmi R174454
Chablani, D42518; Marc Paul Difalzio, D62946
Alhusen, Jeanne L. F N 1613 Maryland Primary Care Physicians R173375
Loraine Dailey, D2
Alperson, Sunny Yim R192556
F N Parvej Malik, D65626 Community Clinic, Inc.
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 2 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Andrakakos, Lissa R079598
AC 1980; Robert Daniel Fliint, Jr., D58527
ospital A Brett Allen Gamma, D5 Shady Grove Adventist H
Andresini, Jo Anne R083297
F N A Shawn Peffall, D57104; Michael David Zang, D54426
Overlea Personal Physicians
Anyanwu, Bibiana R121315
A N Shoaib Hashmi, D31464 Shoaib Ahmad Hashmi, MD
Appleby, Tonya R120938
AC / G , D57727 N Narender Pal Singh Bharaj Maryland Medical First, PA
Augustine, Sharon ical Center R059310
A N Kapil Parakh, D64814 Johns Hopkins Bayview Med
Ayers, Sylvia R138812
A 2 / AC N J. Marc Simard, D4423 Veteran's Administration
Ayers, Sylvia R138812
A / AC N Jason Michael Birnbaum, D56296 ystem (UCMC & HMH) Upper Chesapeake Health S
Bakir, Mariam R150259
G N Ziad Mirza, D41901 Genesis Physician Services
Baldwiin, Andrea 54838 nch R166911
P N Brigitte Widemann, D NIH Pediatric Oncology Bra
Balkam, Jane R062391
P N Dana Lise Silver, D57463 Babies 'n Business, LLC
Barker, Sondra OB Medical Center R142366
/GYN A Conrad Duncan, D45495 MedStar Franklin Square
Baynard, Allison Dawn el, H56873 R174041
F N Patricia Jean Karnes-Amzib Choptank Community Health Systems
Beaver, Stacie R139236
F N Vansant Datta, D18019 Vasant Datta, MD, PC
Becker, Kathleen R064917
A N Nilesh Kalyanaraman, D72746 less Healthcare for the Home
Bernardo, Feestelita R163484
AC N Edward Kasper, D34884 Johns Hopkins Hospital
Beyer-Thistle, Melissa 415 D & Assocs., PA R095831
P N Chandana Chatterjee, D23 Kenneth M. Klebanow, M
Bishop, Catherine AC000814 r
F N Katherine Thornton, D61711 Johns Hopkins Sidney Kimmel Cancer Cente
Bittner, Denise K. R089384
AC N Steven Smith, D18216 Western Maryland Health System
Bolden, Melissa Ramey R122440
A N Gerrit Schipper, D25514 Advanced Laser Skincare
Bonner, Nicole R167886
F N Gregg Wolff, D48127 Wolff Orthopedics
Breasure, Keith AC000316
57385 tes, PA F N Jeffrey Scott Cicone, D Nephrology Associa
Brodie, Sharon R089082
P N Rosalie Marinelli, D30817 Kenneth M. Klebanow, MD & Assocs., PA
Brooks, Sharon Agnes N A 61 R098232
F Stanford Coleman, Jr., D222 Righttime Medical Care
Brown, Katherine J. R168483
F N A James Strachan Houston, D59440; Aubrey Verdun, D66729; Terry
val Military Med. Ctr.
Stambaugh, D58055; Scott Griffith, D63695
Walter Reed National Na
Brown, Susan R066301
N N St. Joseph Medical Center Michael Edward Langbaum, D41343
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 3 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Bryant, Nancy R124971
F N Wayne Donald Bierbaum, D38563 Owensville Primary Care
Bujak, Danuta I. R138146
F N Marc C. Hochberg, D17972 UMD, Sch. Of Medicine
Bunce, Nancy L. A.
y, PA AC000387
A N David Hale Smith, D39887 Bay Hematology Oncolog
Cadena, Jacqueline R111689
F N Allen Nathan Moshell, D69046 Georgetown Dermatology Practice Washington Hospital Center,
Campbell, Jeremiah R179207
F N A Jeffrey Greenwood, D48130
Clark Herbert Willis, D63374; Emergency Service Associates
Campbell, Kristina Trott R190635
F N Howard Goldstein, D26743 Annapolis Internal Medicine
Campbell, Myra R068156
F N Ravi Anandakrishnan, D29071 System Bon Secours Baltimore Health
Capone, Kimberly Ann OBR119420
/GYN N Gerrit Schipper, D25514 Capital Women's Care
Casper, Patricia B. R048103
A / G N Yvette Fouche-Weber, D47790 A Cowley Shock Trauma Univ. of MD Med. Sys., R
Cha, Angela R201633
P N Eduardo Armenta, D14743 Armenta Pediatrics
Chiu, Li-Lin R138342
A N Rita Wutoh, D53915 Bowie State Univ., Henry Wise Wellness Ctr.
Christenson, Nicole Renee 7142 R120698
F N Geoffrey Coleman, D3 Montgomery Hospice
Cibula, Julie M. R114467
AC ialists N Robert Fox, D24773 Horizon Vascular Spec
Clark, Janette Marie tem R164718
AC N Steven Smith, D18216 Western Maryland Health Sys
Clark, Thomas S. R188552
F N Barbara Ann Martinez, D67580 Military Med. Ctr. Walter Reed National Naval
Clarke, Beverly Simpler F / P R109133
N Patrick Shanahan, D36054 Washington College Student HealthCenter
Clarke, Beverly Simpler R109133
F / P N Freddy Orlando Araujo-Vidal, D45628
Chestertown Pediatrics
Cohran, Ethel R101470
F N Randall Paul Wagner, D44957 Washington Adventist Hospital
Crivello, Deborah R050918
A N Julie Lisa Ducharme, D66046 Upper Chesapeake Endocrinology Assocs.
Cromwell, Gale G. R076293
A N Bahador Momeni, D50254 Arundel Physicians Associates
Curry, Jackelin E. R142306
A N Lester Zuckerman, D52963 The Spine Center
Davis, Mary Lou LaComb
D AC001077
P N Robert E. Miller, D24265 Robert E. Miller, M
Delaney, Eileen L. R156760
F N Howard Goldstein, D26743 cine, LLC Annapolis Internal Medi
DeMarco, Sharon R085513
A N Michele Bellantoni, D33316 Johns Hopkins Bayview Care Center
Desir-Gaston, Guylene r. R147669
P N Mary Ogunsanya, D56300 Maryland Children's Health Ct
Dolan, Danielle R156835
F N Steven Fong, D60552 CVS / Minute Clinic
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 4 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Doody, Meghan McGowan N A D61676;
Sithanandam Sadhasivam, D29518 cs, PA
Dwyer R200417
F Lavanya Sithanandam, Takoma Park Pediatri
Duke, Malinda Daniel P N Univ. of MD Pediatric Endocrinology R079677
Debra Counts, D32917
Edmunds, Debra R. R045608
N N Michael Edward Langbaum, D41343 ter St. Joseph Medical Cen
Eick-Benson, Laureen
AC000070
A N Martin Gavin, H37636 Nephrology Associates, PA
Elliott, Ayana R164084
F N A 754; Kashif Ali, D69297; Roopa De Chowdhury,
logy, PA
Thomas Bensinger, D08
D73548; Alida Andrillo-Espinoza, D62607
Maryland Oncology Hemato
Entrup, Stephanie M. R096361
P N Sinai Hospital of Baltimore Joseph Wiley, D32436
Epstein, Randy R077703
A N Letha Healey, D62456 Montgomery Co. Health Dept.
Ezeani, Nkiru R151747
A N Harold Bob, D15872 Five Star Physician Services, LLC
Ezimorah, Janefrances PMH-A 9390 Chinwe R114571
N Evaristus Awele Nwulia, D5 JMJ Healthcare Services, LLC
Fadoju, Mercy PMH-A N Jin H. Joo, D72950 Johns Hopkins Bayview Med. Ctr. R133965 Faulkner, Howard , D56120
Center R176326 PMH-A N Lisa Yvonne Richard Appalachian Behavioral Health
Federline, Cynthia H. 43 R083319
N N Michael Edward Langbaum, D413 St. Joseph Medical Center
Fisch, Andrea B. R107082
F N Luke Elhanan Johnsen, H63003 Baltimore City health Dept.
Fletcher, Kathryn R051699
A N N. Eric Carnell, D35695 Frederick Memorial Hospital
Foerter, Deborah S. Health Connections R100681
F N Charles Benner, D31563 MedStar St. Mary's Hospital /
Fomengia, Yvonne R146729
F N A ; Harold Bob, D15872 Teizu Wolokolie, D73821 Lorien Columbia
Forsyth, Carol Diane p R128058
P N Robert Gibson, D24251 The Pediatric Grou
Fowler, Robyn Denise 58 re R118610
F N Gene Francis Ashe, D310 Frederick Primary Ca
Fox, Karen L. R097054
A N A ; Truong Bao, D57124; Sayed
socs. Anushiravan Dadgar, H51280
Elsayyad, D62435
Montgomery Medical As
Fox, Nicole Briana R162044
F N 63 Univ. of MD Med. Ctr. Michael Eugene Winters, D614
Frackelton, Dorian R158793
F N Kozo Murakoshi, D15418 Honeygo Pediatrics
Franks, Joan V. R061887
A N Luis Gimenez, D46907 Good Samaritan Hospital
Freidberg, Joanna Moore 0929 , PA R090072
A N Joy Madarang-Lewis, D5 Joy Madarang-Lewis, MD
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 5 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Fritz, Carla Michelle Creekmore R139268
P N Michael A. Levitas, D38222 Children's Medical Group
Fryman, Elizabeth A N Nader Tavakoli-Jalili, D41978 Chesapeake Shores Nursing Center R073338 Gambill, Nancy D. R086071
A N Kevin Cullen, D34714 UMMC Greenebaum Cancer Center
Gehring, Janet M. K. 6315 Military Med. Ctr. R168665
P N Joel Clayton Labow, D2 Walter Reed National Naval
Gibbons, Susanne R093831
A / G N Steven Geller, D34613 Centennial Medical Group
Golden, Cassandra R202252
AC N Thomas Scalea, D51654 Univ. of MD Med. Ctr.
Grant, Lori Angela AC000116
PA F N Robert Cox, D53975 Nephrology Associates,
Greenwald, Margaret N. R168298
PMH-A a, D45951 N Wagdi Mohamed Atti Wagdi M. Attia, MD, Ph.D.
Groden, Catherine AC000668
N A ch Institute
F Ellen Sidransky, D34252 NIH Human Genome Resear
Groncki-Meninger, Patricia F / P Mark Melzer, D33162; Jack Soong, ased Health Centers Fink
R040613
A Linda Grossman, D23682;
D45934
Baltimore Co. Public Schools / School-B
Haldeman, Sandra OB/GYN N 99 R123536
Cyrus Jefferson Lawyer, III, D292 Total Health Care
Harper, Moncheri R182026
F A Stanford Coleman, Jr., D22261 Righttime Medical Care
Harrison, Barbara Ruth PMH-A Group R143706
N Eugenio Machado, D24035 Erickson Health Medical
Hart-Johnson, Mary AC001073
F N Osama Saleh, D50397 Calvert Co. Health Dept.
Hearn, Jacqueline R069707
A N John Middleton, D25443 John W. Middleton, MD
Heatwole, Joy AC000807
1 A N Romaldo DeSouza, D4624 Genesis Healthcare
Hennessee, Aretha A. spital R138505
A N Issam Cheikh, D14748 Union Memorial Ho
Henry, Kierstein R147170
AC N Roger Leonard, D28791 cal Center MedStar Montgomery Medi
Hileman, Kristen Susannah N A ; Willie Leon Stertz, Jr., D65406 R201732
F Carissa Jean Vea, D69419 WMHS Primary Care Center
Hobson, Sharon K. R070337
P A Linda Grossman, D23682; Mark Melzer, D33162; Jack Soong,
/ School-Based Health Centers
D45934
Baltimore Co. Public Schools
Holquist, Benjamin M. R128062
A / AC N l Paul Massimiano, D32297 Washington Adventist Hospita
Howard, Kathleen R130360
P A Linda Grossman, D23682; Mark Melzer, D33162; Jack Soong, School-Based Health Centers D45934
Baltimore Co. Public Schools /
Huffstutler, Rebecca AC000617
F A ge, David Page, D33050; David PaD33050
Kaiser Permanente
Imam, Susan R124053
N N Muhammad Farooq, D65608 Union Hospital
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 6 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Ingram, Miriam gement R051001
A N Garry Jennings, D42216 QOL Pain Mana
Jamison, Pickett Kendall OBCenter R167602
/GYN N Andrew Satin, D37611 Johns Hopkins Bayview Medical
Jegannathan, Sumathi AC001027
A N Luis Zuniga, D26294 Zuniga Primary Care
Jenkins, Lisa W. R084836
F N Jose T. Loveria, D50844 p Braddock Medical Grou
Johnson, Pamela P. PMH-A 4254 R172158
N Beatrice A. Denefield, D0 Total Health Care
Johnson, Penny Fleetwood
C AC000016
F N Steven Hearne, D40715 Delmarva Heart, LL
Jones, Patricia R131102
AC Thomas Scalea, D51654; Scott Strome,
A Thomas Scalea, D51654;
D62627; Howard Eisenberg, D43894
Univ. of MD Med. Ctr.
Jordan, Jennifer A. R136351
F N Montgomery Hospice Geoffrey Coleman, D37142
Kahl, Michelle Anne al R123286
A N Daniel Picard, D45507 Franklin Square Hospit
Kamendi, Janet R178619
F N Imran Chowdhury, D42019 nter Infectious Disease Care Ce
Keener, Martha R162682
F N A illiam Hand, D57145; Robin Motter-Mast, Sarah Whiteford, D57105; W
H56488; Joseph Connelly, D30133
Target Clinic
Kim, Tao R149755
F N Dermatology & Cosmetic Surgeries Eric Finzi, D40882
Koch, Jane Stover A 0 R094907
/ G N Charles Hoesch, D2039 VAMHCS Perry Point
Kohl, Carole Benisch ical Center R116637
A N Muhammad Jokhadar, D60768 Upper Chesapeake Med
Komolafe, Johnson A. R123830
A N Corry Chapman, D69141 Precision Nursing Consult
Krakovsky, Gina Michelle Mark Melzer, D33162; Jack Soong,
ls / School-Based Health Centers R192300
P A Linda Grossman, D23682;
D45934
Baltimore Co. Public Schoo
Kramer, Susan Rae R085027
A N Stephen Kay, D27258 Stephen R. Kay, MD
Lancos, Elizabeth R092253
P N Jacqueline Ann Brown, D41853 , MD & Assocs., PA Kenneth M. Klebanow
Larimore, Alyssa Kay OB s. R139855
/GYN N Jean Hundley, D35784 Womankind OB/GYN & Assoc
Lee, Jooyoung J. R177197
AC N Thomas Scalea, D51654 Univ. of MD Med. Ctr.
Lester-Garrett, Kelley 66022 Suzanne AC000927
F N Jagdeep Singh Hundal, D Union ENT
Letzer, Melanie G N Narender Bharaj, D57727 Maryland Medical Group R133532 Letzer, Melanie R133532
G N Shakunmala Gupta, D53150 Shakunmala Gupta, MD
Levasseur, Kandy Fink R122010
P N Michael A. Levitas, D38222 Children's Medical Group
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 7 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Lewis, April Lynne R080110
A N Gabor David Kelen, D30854 Johns Hopkins Adult ED
Li, Dongmei R144722
A N A rt Fox, D24773; Zahide Erkman,
spital Dennis Friedman, D24971; Robe
D54938
Shady Grove Adventist Ho
Lindsey, Carol L. R194473
F N Mobile Medical Care Helen Blumen, D41605
Logan, Janis Langley OB 50546 ical Center R070172
/GYN N Joan Lewis Blomquist, D Greater Baltimore Med
Manzo, Joanne R028167
P N Deborah Weber, D26490 Mercy Medical Center
Marshall, Lisa Schnoor 38 LC R174127
F N William Edwin Bair, D432 William E. Bair, MD, L
Masiulis, Barbara R132625
P A Linda Grossman, D23682; Mark Melzer, D33162; Jack Soong, School-Based Health Centers D45934
Baltimore Co. Public Schools /
Mattox, Patty R146293
A / AC N al Center
Eric Edwin Howell, D54801 Johns Hopkins Bayview Medic
Mayhew, Maren S. N A na Marie Leskuski, H66665 R057293
A Jay H. Lippman, D25001; Do Capital Caring
Mays, Jennifer Jean R124625
F N Narender Bharaj, D57727 Maryland Medical First
Mays, Jennifer Jean R124625
F N Damien Jay Doyle, D57884 Evercare -- Maryland
McCloskey, Tracey Anne A R068299
/ G N Charles C. Reel, D44697 Charles C. Reel, MD
McGurin, Mary Elizabeth Bryant R090583
O osley, D67375
MD B/GYN A Raegan Elise McDonald-M Planned Parenthood of
McLean, Carol A N hillon, D58860 Calvert Medical Group R131588
Shawn D
McManus, Sister Cecilia Center R081762
A N Charles Stegman, D25219 Catholic Charities Seton
McNeil, Marianne R172352
F N Michael Eugene Wintes, D61463 Univ. of MD Med. Ctr.
Meadows, Rita Elizabeth Jean AC000997
F N Rachel Gafni, D59393 Camp Possibilities
Medeiros, Lisa F N A Michael S. Epstein, D34426; Charles Edmond King, Jr., D41618; Barry
Digestive Disorders Associates, PC R089995
Joel Cukor, D69388; Vishnupriya Krishna, D69477
Menino, Camille R107936
A N A ; Salome Hawkins-
Heartlands Hospice Svcs., Baltimore
Donna Eversley, D54739; Nader Tavakoli, D41978Cole, H46961
Mercado, Nancy J. Habersat
F N hildren's Health Ctr.
R066109
Mary Ajoke Ogunsanya, D56300 Maryland C
Merli, Erin Beyer P N Charles Livingston Parmele, D57434 Annapolis Pediatrics R178315 Miller, Amy Donato AC r R131368
N Stephen Schenkel, D60024 Mercy Medical Cente
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 8 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Miller, Robin R202623
AC N Robert Michael Benitez, D40978 Univ. of MD Med. Ctr.
Montague, Mamie olford Infirmary R075702
F N Ngozi Ruth Agwuna, D44795 Morgan State Univ., Wo
Moragne-Coon, Yvonne R075730
A N Frances Gheorghiu, D24381 Stem-Ross Weight Loss Center
Mossburg, Dawn Renee R100955
OB N A 09; Debra Acerenza, H58788; Jie Gao,
/GYN Edwin Tieh-Tsung Chen, D433
D67663
OB & GYN Center
Munson, Kathryn A. R172054
OB/GYN A Planned Parenthood of MD Raegan Elise McDonald-Mosley, D67375
Myers, Kelley R178372
F N Mary Rifino, D43418 Minute Clinic
Neal, Dawn Carol Chapelle ansky, D51603 R125889
P N Raphaela Goldbach-M NIH
Newsome, Christine O. R152794
F N Stephen Naylor, H55026 West Cecil Health Center
Ninan, Jiji John R097618
F N David B. Wilson, Jr., D56824 ine Center for Geriatric Medic
Njoku, Patricia R095655
A N Isabel Christine Green, D67681 Women's Health @ Johns Hopkins Outpatient Center
Norris, Donna Yvonne Care R097479
F N Frederick Paul Beavers, D60615 Calvert Memorial Hospital, The Center for Vascular
Nwaeze, Stella N. R131641
A N Ahmed Heshmat, D57574 Montgomery Co. Correctional Facility
Oguike, Nkechinyere N A ; Maria Soriano, D56301 Ngozi
R113220
P William Paul Jaquis, D57429 Sinai Hospital of Baltimore
Okoro, Eunice A. F N 0359 Bon Secours Hospital R132487
Ikemba Iweala, D4
Ordun, Joyce W. R051050
F N Mitchell Goldstein, D53248 l Johns Hopkins Hospita
Pack, Eileen Marie AC001006
F N Jui-Chih Hsu, D04823 Family Medical Care
Palker, Nancy R173419
G N Geoffrey Coleman, D37142 Montgomery Hospice
Palmer, Beth C. Center R177669
AC A Robert Peterson, D24804 Anne Arundel Medical
Pandian, Vinciya N A 40167; Nasir Islam Bhatti, D51255; Elliott
-R142853
AC Marek Alexander Mirski, D
Richard Haut, D61858; David FellerKopman, D66132
Johns Hopkins Hospital
Pappas, Dawn M. R111356
AC N Johns Hopkins Hospital, CVPCU John Victor Conte, Jr., D47828
Parler, Penni Eugenia Assocs., PA R119137
P N James David Anthony, D35387 Kenneth M. Klebanow, MD &
Passwaters, Diana L. R125725
F N Savinder Julka, D27188 Genesis Heritage Nursing Home
Paynter, Doreen R077125
AC 70 N Benjamin Landrum, D579 Infectious Disease Associates
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 9 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Pierre, Joseline R122476
AC A Anushiravan Dadgar, H51280; Sayed Elsayyad, D82435; Truong Bao, D57124
Montgomery Medical Assocs.
Plowden, Keith O. R139066
PMH-A N Beatrice A. Denefield, D04254 Total Health Care, Inc.
Prussian, Kathleen R192493
F N Lester Zuckerman, D52963 The Spine Center
Pullen, Dawn Kimberly R072251
A N Nayan Vaywala, D23443 Drs. Vaywala & Ahn
Purcell, Ann R103493
P N Dinea DeSouza, D54977 Montgomery Co. School-Based Health Ctrs.
Radegaugh, Lisa Carroll R080294
A N John O'Donnell, D35423 Union Memorial Sports Medicine
Randolph, Veronica D. R110705
A N Jean Estime, D55724 Charlotte Hall, CBOC
Reed, Vera L. R067884
P N Dinea DeSouza, D54977 Montgomery Co. School-Based Health Ctrs.
Reinard, Phylis D. R070594
P N Dianna Elizabeth Abney, D43633 Charles Co. Dept. of Health
Reyes, Viviana Andrea AC001071
F N A Maureen Donnelly Passaro, D44487; John Reyes-Castano, D74176
MedStar Montgomery Medical Center
Rice, Lorri A. R063326
F N Mary Money, D23815 Waldman & Money, PA
Ricker, Amy Marie R173595
F A Michael Freedman, D52245; Howard Goldstein, D26743; Titus Chotheakadavil Abraham, D56658
Annapolis Internal Medicine
Ricker, Any Marie R173595
F N A Neek Kiran Vibhaker, D61331; Joel Eli Klein, D61331
Baltimore Washington Emergency Physicians, Inc.
Riggs, Cassandra B. R108930
F N Verlyn O. Warrington, D46581 UMBC University Health Svcs.
Rochelle, Maureen R056461
P A Linda Grossman, D23682; Mark Melzer, D33162; Jack Soong, D45934
Baltimore Co. Public Schools / School-Based Health Centers
Rolph, Sandra M. R202981
F N Rena M. Johnson, D37270 Kimborough Ambulatory Care Clinic, Warrior Team
Ross, Anna Amour R135224
PMH-F N A Enoch Barrios, D62113; Lourdes Angelica Villacis, H62196
Walter Reed National Naval Military Med. Ctr.
Royce, Cheryl R124005
A A Teri Nguyen Kreisl, D74283; Teri Nguyen Kreisl, D74283; Howard Fine, D55925
National Cancer Institute/NIH
Ruane, Kathleen P. R060797
A N W. Anthony Riley, D25205 GBMC -- Gilcrest Greater Living
Ruddle-Frey, Jennifer Elizabeth R135106
F N Hung Davis, D53111 Maryland Inpatient Care Specialists
Ryan, Judith W. R051691
A N Rebecca Elon, D41955 FutureCare Health & Management Corp.
Sampson, Pamela Bohler R193319
F N Simona Sirbu, D67891 Montgomery Health Center, LLC
Sanford, Mary Alice R078363
A N Lester Zuckerman, D52963 The Spine Center at the Center for Pain Management
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 10 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Saunders, Dawn Lorraine R092695
N N Karen Broderick, D35190 St. Agnes Hospital
Savoy, Marina Vanessa R134295
A N Joseph M. Haggerty, D32407 Associates in Oncology & Hematology
Scheu, Karen R174980
F N Pablo Dibos, D04683 The Esperanza Health Center
Seagle, Reema Sbitany R185643
N N Sharon Coyle Kiernan, D46711 Holy Cross Hospital Community Neonatal Assocs.
Serafini, Jo Ann R148953
P N Daung Silpasuvan, D22317 D&S Silpasuvan
Setola, Tamara Jeanne R114538
P N Najla Abdur-Rahman, D59823 Willoughby Beach Pediatrics
Shafer, Susan Lori R070032
F N Ugandhar Rao Vemulapalli, D63598 Man Alive
Sharkey, Brian C. R137750
A N Andrew Lazris, D47447 Personal Physician Care
Shiner, Mary R053281
P A Linda Grossman, D23682; Mark Melzer, D33162; Jack Soong, D45934
Baltimore Co. Public Schools / School-Based Health Centers
Siever, Beth A. R147488
P N A Jeffrey Dome, D46149; Jay Greenberg, D34360
Children's National Medical Ctr. Regional Outpatient Ctr.
Siltman, Stephen F. R126177
AC N Jeffrey Greenwood, D48130 Emergency Service Associates/PRMC/AGH
Simm, Caroline R175798
F N Kellie Bobbitt Smaldore, H40582 Smaldore Family Practice
Slear, Elaine Marie R041641
A N Reza Alavi, D67215 Turning Point Clinic
Smith, Janine R119344
A N Gregory Kumkumian, D57032 Suburban Hospital
Smith, Kate Meredith R128088
A N Muhammad Khalid Waseem, D52323
Opal Medical Group, PA
Somervell, Helina R117393
F N Martha Zeiger, D36424 Johns Hopkins Hospital
Sommer, Matthew R137599
F N Carrie Deanne Dorsey, D63451 Edgewood Area Health Clinic / Kirk US Army Health Clinic
Speller-Brown, Barbara Jean R151230
P N Deepika Darbari, D52844 Children's National
Stafford, Jaimie Lynne R172458
PMH-A A Murray Frances Claytor, D47957 St. Lukes House
Stafford, Jaimie Lynne R172458
PMH-A N Oludolapo Kale, D67842 Patuxent Institute
Stafford, Jaimie Lynne R172458
PMH-A N Michael Fingerhood, D35761 BHLI Suboxone Program
Stanfield, Cathy L. R086517
AC N Charles S. Angell, D12405 Johns Hopkins Hospital
Stevenson, Terry Lynn R093935
A N Robert Stone Baxt, D13335 Stem-Ross Weight Loss Center
Stevenson, Terry Lynn R093935
A N Serena Rose Nolan, D25010 Serena Nolan, MD
Stresky, Linda S. T. R060312
F N Rosario Gonzaga, D22277 Rosario B. Gonzaga, MD, PA
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 11 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE Sullivan, Kerrie R121234
F N Brian Sullivan, D50954 Maryland Brain & Spine
Terle-Bird, Hope R111787
P N James David Anthony, D35387 Kenneth M. Klebanow, MD & Assocs., PA
Tesfai, Hadas R120149
A N Venkataraman Chandar, D16380 Affiliated Digestive Disease Specialists
Teufel, Claire R046288
A N Verlyn O. Warrington, D46581 UMBC University Health Svcs.
Tibbo, Michele Leigh R131381
AC N Michael Eugene Winters, D61463 Univ. of MD Med. Ctr.
Todd, Grace Ihsiu R170895
A N Ronald Rodriguez, D53182 Johns Hopkins Medical Institutions
Toney, Carol F. R077347
F N A Charles Berul, D69742; Jonathan Kaltman, D65992; Jeffrey Moak, D42415; Anne Greene, D35462
Children's National Medical Ctr.
Troxler, Laurene Lee AC000320
G N Romaldo Francis Desouza, D46241 Genesis Physician Services
Trumble, Loretta Vizioli R122160
OB/GYN N A Francisco Rojas, D64450; Kimberly Turner, D47703; Natalia Guzman, D69489; Andrea Kwong, D62005; Maureen Grundy, D72755; Nia Leak, D73027
Johns Hopkins Community Physicians
Turpin, Anna R177665
P N Travis Ganunis, D53176 Pavilion Pediatrics at Johns Hopkins Greenspring Station
Valle, Mary Frances R094002
A N Mary MacGregor, D13657 Roland Park Place
Venuti, Kristen R150660
P N Paul D. Sponseller, D33880 Johns Hopkins Hospital
Wahl, Colleen E. R136242
F A David Raymond Adams, D60578; David Raymond Adams, D60578; Fred A. Gill, D01119
National Institutes of Health
Walk, Cheryl L. R108228
AC A Jason Michael Birnbaum, D56296; Stephen Robert Selinger, D28717
Upper Chesapeake Medical Center
Wamboldt, Carol R156968
A N Michael Alan Williams, D40041 Michel Mirowski Medical Office Bldg. Dept. of Neurology
Warczynski, Tam Mara R088501
A / AC N Timothy Pawlik, D63560 Johns Hopkins Hospital
Washington, Angela D. R102625
F N John Kenzora, D22289 Baltimore Veterans Administration Medical Ctr.
Waterfield, Geraldine Daley R039279
P N Judith DeBose, D57520 Baltimore City Health Dept.
Watkins, Carol R133381
A / G N Jude Muneses, D53462 Heritage Center -- Genesis
Webb, Cherrie R119145
AC N A David Morris Brill, D36601; Sung Woo Lee, D37960
Washington Adventist Hospital
Weichold, Anne R111182
AC A Carl Barton Shanholtz, D38683; Carl Barton Shanholtz, D38683; Daniel Herr, D31590
Univ. of MD Med. Ctr.
Wells, Rebecca R154360
F N Steven Fong, D60552 Minute Clinic
NP ATTESTATIONS & ADDENDUMS RECOMMENDED FOR APPROVAL – SEPTEMBER 25, 2012
Page 12 of 12 *TYPE: N = New Attestation N A = New Attestation w/Addendum Sheet A = Existing Attestation Amended
STATE OF MARYLAND
NP NAME CERT. TYPE* COLLABORATOR(S) SITE White, Junecia R127474
F N Ernestine Wright, D52740 Stella Maris
Williams, Jeannette Alice AC000226
F A David Page, D33050; David Page, D33050
Kaiser Permanente
Williams, Paulette A. R108262
F / OB/GYN
N Maria Trent, D57779 Baltimore City Health Dept.
Williams, Paulette A. R108262
F / OB/GYN
N Victor Khouzami, D21732 Greater Baltimore Medical Center
Wingate, Suzanne R066241
A N Carol Patrice Cardinale, D60492 Kaiser Permanente
Winkfield, Devora Renee R127475
F N Samuel DeShay, D19935 Restore Health
Wippel, Mary Ann R115364
A / AC N Reza Alavi, D67215 Turning Point Clinic
Wu-Gerrard, Yamileth R154852
G N Robert W. Cox, D53975 Nephrology Associates, PA
Wyatt, Cheryl N. R131556
F N Jeremy David Tucker, H63519 MedStar -- St. Mary's Hospital, Medical Emergency Professionals
Yarnbold, Beth D. R077638
G N David S. Dunn, D32299 Harford Primary Care
Young, Cheryl Lynn R188246
AC A Stephen Neil David, D48400
Univ. of MD Med. Ctr.
Young, Patricia D. R108162
F N A Obafemi Okuwobi, D70367; Malini Joel, D62044
Johns Hopkins Community Physicians
Zoltak, Brenda R101670
P N Charles Livingston Parmele, D57434 Annapolis Pediatrics
Zurek, Elizabeth R128085
A N Cynthia Carol Mobley, D40332 Baltimore City Health Dept.
Zwicker, Celia DeAnne AC000335
A N Ravi Passi, D28656 Advanced Primary & Geriatrics Care
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