Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R077345 | MD |
NPI | 1003100652 |
---|---|
Provider Name | Ms. Regina Marie Toal |
First Address | Abingdon, MD 21009-3221 |
Second Address | Havre De Grace, MD 21078-2147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2011 |
Last Update Date | 31/05/2011 |