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Individual

MARYJO SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
234 HARBOR DR, LUSBY, MD 20657-2714
(410) 474-2032
(240) 718-1709
Mailing address
234 HARBOR DR, LUSBY, MD 20657-2714
(410) 474-2032
(240) 718-1709

Taxonomy

Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
R076273
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R076273
NURSING LICENSE
MD
Enumeration date
04/27/2020
Last updated
04/27/2020
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