Provider Demographics
NPI:1558469817
Name:ROTHMAN, MAIRI BREEN (CNM MSN)
Entity Type:Individual
Prefix:
First Name:MAIRI
Middle Name:BREEN
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:CNM MSN
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7301 GARLAND AVE
Mailing Address - Street 2:M.A.M.A.S., INC.
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6417
Mailing Address - Country:US
Mailing Address - Phone:301-674-9976
Mailing Address - Fax:185-528-2072
Practice Address - Street 1:7301 GARLAND AVE
Practice Address - Street 2:M.A.M.A.S., INC.
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6417
Practice Address - Country:US
Practice Address - Phone:301-674-9976
Practice Address - Fax:855-282-0727
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR116258367A00000X
DCRN59212367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife