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Individual

MRS. MARY JO LANPHEAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1837 PULASKI HWY, EDGEWOOD, MD 21040-1609
(410) 612-1657
Mailing address
2515 FAIRWAY DR, BEL AIR, MD 21015-6352
(410) 836-5016

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R096598
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R096589
NURSING LICENSE
MD
Enumeration date
03/16/2007
Last updated
07/08/2007
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