Provider Demographics
NPI:1326246661
Name:SHINER, MARY HEALY (RN, MS, CPNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HEALY
Last Name:SHINER
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-4425
Mailing Address - Country:US
Mailing Address - Phone:410-335-2607
Mailing Address - Fax:
Practice Address - Street 1:1740 TWIN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3526
Practice Address - Country:US
Practice Address - Phone:410-887-4456
Practice Address - Fax:410-887-4456
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR053821363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics