Individual
MS. THERESA J GAGEN-HURSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNPNP
Contact information
Practice address
10807 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4591
(410) 321-9393
(410) 825-4945
Mailing address
10807 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4591
(410) 321-9393
(410) 825-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N51181
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL96MA
BLUE SHIELD OF MD
MD
Enumeration date
03/27/2008
Last updated
10/01/2010
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