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Individual

TONI LILLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
6340 SECURITY BLVD STE 100B8, GWYNN OAK, MD 21207-5173
(443) 804-2294
Mailing address
832 CRYSTAL PALACE CT, OWINGS MILLS, MD 21117-2256
(443) 804-2294

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R213894
MD
376K00000X
Nurse's Aide
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
210590000
MD
Enumeration date
01/03/2025
Last updated
01/03/2025
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