Provider Demographics
NPI:1609880749
Name:MULFORD, MARY K (CRNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:MULFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-337-8888
Mailing Address - Fax:410-823-4823
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-337-8888
Practice Address - Fax:410-823-4823
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR059991363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner