Individual
STACEY ENGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
244 GOLDEN RAIN LN, BEL AIR, MD 21015-2018
(410) 688-3935
Mailing address
244 GOLDEN RAIN LN, BEL AIR, MD 21015-2018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R090108
MD
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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