Individual
ANN DEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7700 DUNMANWAY, DUNDALK, MD 21222-5436
(410) 887-7182
Mailing address
1700 PARKVUE RD, FALLSTON, MD 21047-2242
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
RO37837
MD
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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