MARYLAND BOARD OF PHYSICIANS

Collaboration Agreement Receipt of Completion

PA License Number:  C0007830 KRISTINE NELL BIZZARRO
Collaboration Agreement No:
188
Submit Date:
10/11/2024
Confirmation No:
188_1126C0007830

Section 1 - Physician Assistant Information
Confidential Information redacted.

Section 2 - Primary Practice Setting & Location:
Practice Type:
Hospital
Facility
Union Hospital Of Cecil County
Address
106 Bow Street
Elkton  MD 21921 
County
Cecil
Includes Telehealth?
YES
Is this the location where a copy of your collaboration agreement is on file?  YES
A copy (paper or electronic) must be immediately available upon request by the Board.

Section 3 - Advanced Duties and Prescriptive and Dispensing Authority
1.Does this Collaboration Agreement include Advanced Duties? NO

2. Does this Collaboration Agreement include prescriptive authority? YES

3. Does this Collaboration Agreement include dispensing authority under a physician's active dispensing permit? NO