Individual provider · Type 1 NPI
Shirley Jane Sample, C.R.N.P.
Adult Health Nurse Practitioner · Lutherville, MD
NPI number
1417019936
Active
Practice location
1300 Bellona Ave Ste B
Lutherville, MD 21093-5466
Mailing address
11525 Hannibal Rd
Glen Arm, MD 21057-9207
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | R080367 (MD) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1417019936
Shirley Jane Sample, C.R.N.P.'s National Provider Identifier is 1417019936, issued on Dec 14, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Lutherville, MD. The record was last updated on Aug 20, 2014.