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Individual

HOLLY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1165 IMPERIAL DR STE 200, HAGERSTOWN, MD 21740-6583
(301) 665-9098
(301) 665-9096
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
R190986
MD
363L00000X
Nurse Practitioner
Primary
R190986
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R190986
LICENSE
MD
Enumeration date
10/26/2016
Last updated
01/19/2024
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