Individual provider · Type 1 NPI
Mary Gordon Walter, RN/NP, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Prince Frederick, MD
NPI number
1023449642
Active
Practice location
976 Solomans Island Road
Prince Frederick, MD 20678
Mailing address
975 Solomons Island Rd N
Prince Frederick, MD 20678-3917
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Registered Nurse | 163WE0003X | RN2274139 (MA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2274139 (MA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R217581 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1023449642
Mary Gordon Walter, RN/NP, PMHNP-BC's National Provider Identifier is 1023449642, issued on Dec 7, 2013. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Prince Frederick, MD. The record was last updated on Sep 29, 2015.