Provider Demographics
NPI:1366647695
Name:VERDERAIME, MARIA KIMBERLY (RVT, RN, DHERB)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:KIMBERLY
Last Name:VERDERAIME
Suffix:
Gender:F
Credentials:RVT, RN, DHERB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 RUNKLES RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-7319
Mailing Address - Country:US
Mailing Address - Phone:301-703-9591
Mailing Address - Fax:
Practice Address - Street 1:6805 RUNKLES RD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-7319
Practice Address - Country:US
Practice Address - Phone:301-703-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education