Individual
SHANITA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 COMMODORE DR, ESSEX, MD 21221
(410) 365-4222
Mailing address
107 COMMODORE DR, ESSEX, MD 21221
(410) 365-4222
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R178613
MD
Other
Enumeration date
08/19/2014
Last updated
07/20/2022
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