Provider Demographics
NPI:1710107974
Name:CAPEK-OVERMIER, MARY-ELLEN (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:MARY-ELLEN
Middle Name:
Last Name:CAPEK-OVERMIER
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 EARLHAM AVE
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1502
Mailing Address - Country:US
Mailing Address - Phone:410-721-7743
Mailing Address - Fax:
Practice Address - Street 1:2020 TILGHMAN DR
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1742
Practice Address - Country:US
Practice Address - Phone:410-451-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR110691163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool