Individual
TINA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1475 TANEY AVE, FREDERICK, MD 21702-4747
(301) 662-1930
Mailing address
1475 TANEY AVE, FREDERICK, MD 21702-4747
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R225035
MD
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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