Individual
CAROL SUSAN THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1700 REISTERSTOWN RD, SUITE 214, BALTIMORE, MD 21208-1416
(410) 486-8303
Mailing address
1700 REISTERSTOWN RD, SUITE 214, BALTIMORE, MD 21208-1416
(410) 486-8303
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R196699
MD
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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