Individual
KERMIT MIDTHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
4705 HARPERS FERRY RD, SHARPSBURG, MD 21782-1608
(240) 527-8118
Mailing address
4705 HARPERS FERRY RD, SHARPSBURG, MD 21782-1608
(240) 527-8118
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R135790
MD
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
667261
CA
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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