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Individual

LOC M THOMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2001 MEDICAL PKWY, ACUTE CARE PAVILION, ANNAPOLIS, MD 21401-3280
(443) 481-1000
(410) 266-1642
Mailing address
PO BOX 64916, BALTIMORE, MD 21264-4916
(443) 481-6481
(443) 481-6515

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R151186
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
335514400
MD
01
607156012
US DEPARTMENT OF LABOR
01
8029100
AETNA HMO
01
97430801
CAREFIRST
MD
01
9830738
AETNA PPO
01
V8140013
CAREFIRST
Enumeration date
04/01/2011
Last updated
07/29/2011
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