Individual
MARY LYNNE MCDOUGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 BROWN ST, CHESTERTOWN, MD 21620-1435
(410) 778-3300
(410) 810-7180
Mailing address
PO BOX 120, 202 MAPLE AVE STE B, CHESTERTOWN, MD 21620-0120
(410) 810-7055
(410) 810-7054
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AC000388
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68639503
BCBS MD
MD
05
—
8938938
—
VA
01
—
F232 0013
BCBS
DC
Enumeration date
06/09/2005
Last updated
09/05/2007
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