Individual
MRS. TERESA MARIE LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
265 MILL ST, SUITE 800, HAGERSTOWN, MD 21740-6130
(240) 513-4595
(240) 513-4596
Mailing address
265 MILL ST, SUITE 800, HAGERSTOWN, MD 21740-6130
(240) 513-4595
(240) 513-4596
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R109055
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807602200
—
MD
Enumeration date
07/04/2006
Last updated
09/30/2021
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