Bourbon, Mary
Bourbon, Mary is an individual health care provider with primary practice located at 1600 S. Cain Highway Suite 401, Glen Burnie MD 21061. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bourbon, Mary can be contacted via phone (410) 768-5050.Contact Information
Primary practice address
1600 S. Cain Highway Suite 401
Glen Burnie MD 21061
Phone: (410) 768-5050
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R089401 | Maryland |
Profile Details
| NPI number | 1023499548 |
|---|---|
| LBN Legal business name | Bourbon, Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2015 |
| Last updated | Jun 2nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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