Individual
MARY ALICE OLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4775 ILKLEY MOOR LN, ELLICOTT CITY, MD 21043-6531
(443) 904-2099
Mailing address
4775 ILKLEY MOOR LN, ELLICOTT CITY, MD 21043-6531
(443) 904-2099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R199404
MD
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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