Individual
REBECCA J. MYSIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2339 MAYTIME DR, GAMBRILLS, MD 21054-1434
(410) 241-1806
Mailing address
2339 MAYTIME DR, GAMBRILLS, MD 21054-1434
(410) 241-1806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R202955
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F11190441
—
MD
Enumeration date
02/07/2020
Last updated
02/07/2020
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