Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon K Idzik, CRNP

Individual provider Primary Care Nurse Practitioner · NPI 1467445924

Shannon K Idzik, CRNP is a Nurse Practitioner in Baltimore, Maryland. Qualified in 2003, 23 years ago. Practices with Upper Chesapeake Primary Care, LLC, a 17-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
23
Licensed in
MD
In the registry since
2005
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

655 W Lombard St 345
Baltimore, MD 21201-1512
Phone: (410) 706-8129
Fax: (410) 706-0344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence R131534 (MD)

Record details

NPI number1467445924
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedAugust 30, 2005
Last updated in NPPESJanuary 10, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Upper Chesapeake Primary Care,Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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