Provider Demographics
NPI:1467419671
Name:FORBES, MARY T (CRNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:FORBES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:T
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8755 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2505
Mailing Address - Country:US
Mailing Address - Phone:410-726-5677
Mailing Address - Fax:
Practice Address - Street 1:522 CYNWOOD DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3876
Practice Address - Country:US
Practice Address - Phone:410-822-5600
Practice Address - Fax:410-822-1769
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR067417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD655550100Medicaid