Individual
TIA L FIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1165 IMPERIAL DR STE 300, HAGERSTOWN, MD 21740
(301) 665-9098
(301) 665-9096
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339
(301) 340-9027
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
T20140848
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNM2335
AMERICAN MIDWIFERY CERTIFICATION BOARD
MD
01
—
R213754
STATE LICENCE
MD
Enumeration date
10/10/2014
Last updated
10/09/2023
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