Individual
MARIAN NSO MBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15017 NORTHCOTE LN, BOWIE, MD 20716-1044
(240) 486-7304
Mailing address
15017 NORTHCOTE LN, BOWIE, MD 20716-1044
(240) 486-7304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R194096
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN194096
REGISTERED NURSE
MD
Enumeration date
12/02/2013
Last updated
08/02/2022
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