Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AC002051 | MD |
NPI | 1033641089 |
---|---|
Provider Name | Hilarie Lynn |
First Address | Baltimore, MD 21204-6819 |
Second Address | Baltimore, MD 21204-6819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2017 |
Last Update Date | 27/07/2017 |