Provider Demographics
NPI:1548747710
Name:SMITH, MARY ANNE (MSN, DNP, RN, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, DNP, RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 YORK RD STE 360
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7465
Mailing Address - Country:US
Mailing Address - Phone:410-847-7171
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 360
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7465
Practice Address - Country:US
Practice Address - Phone:410-847-7171
Practice Address - Fax:443-319-1116
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235450363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health