Provider Demographics
NPI:1750035580
Name:YASIN, MAIRE (FNP-C)
Entity Type:Individual
Prefix:
First Name:MAIRE
Middle Name:
Last Name:YASIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 LITTLE PAX RUN
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1867
Mailing Address - Country:US
Mailing Address - Phone:571-314-5629
Mailing Address - Fax:
Practice Address - Street 1:6502 KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1370
Practice Address - Country:US
Practice Address - Phone:301-927-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC004084363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care