Individual
MERCY LAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7995 NOLPARK CT, # 102, GLEN BURNIE, MD 21061-5214
(410) 969-6374
Mailing address
7995 NOLPARK CT, # 102, GLEN BURNIE, MD 21061-5214
(410) 969-6374
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP40862
MD
Other
Enumeration date
12/20/2007
Last updated
12/20/2007
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