Individual
MIA CAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 BAYLAND DR UNIT 21, HAVRE DE GRACE, MD 21078-4236
(929) 326-7531
Mailing address
108 BAYLAND DR UNIT 21, HAVRE DE GRACE, MD 21078-4236
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R243796
MD
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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