Individual
MS. AMANDA GOUIN LARKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5230 CAMPBELL BLVD, NOTTINGHAM, MD 21236
(410) 933-9680
Mailing address
5230 CAMPBELL BLVD, NOTTINGHAM, MD 21236-4983
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R187745
MD
363AM0700X
Medical Physician Assistant
Primary
C06220
MD
Other
Enumeration date
08/09/2012
Last updated
08/15/2018
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