Individual
MISTY MARLENA VASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, IBCLC
Contact information
Practice address
15007 SCOTTSWOOD CT, WOODBINE, MD 21797-8333
(865) 660-9682
Mailing address
15007 SCOTTSWOOD CT, WOODBINE, MD 21797-8333
(865) 660-9682
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R219313
MD
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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