Individual
THELMA E PAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
22 W PADONIA RD, LUTHERVILLE TIMONIUM, MD 21093-2226
(419) 280-0962
Mailing address
913 SOUTHERLY RD APT 205, TOWSON, MD 21204-2621
(419) 280-0962
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
377629
OH
163W00000X
Registered Nurse
R241784
MD
363LF0000X
Family Nurse Practitioner
CNP024225
OH
363LF0000X
Family Nurse Practitioner
Primary
R241784
MD
Other
Enumeration date
05/01/2012
Last updated
02/23/2021
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