Individual
MAXINE A WALLEN-LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1380 PROGRESS WAY STE 102, ELDERSBURG, MD 21784-6498
(410) 795-0257
Mailing address
200 MEMORIAL AVE, PAYOR CREDENTIALING DEPARTMENT, WESTMINSTER, MD 21157-5726
(410) 871-6864
(410) 871-6516
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R119466
MD
Other
Enumeration date
06/11/2022
Last updated
01/08/2026
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