Provider Demographics
NPI:1215562756
Name:THOMAS, MAURA MCDONNELL (CRNP)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:MCDONNELL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 RIVER CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7721
Mailing Address - Country:US
Mailing Address - Phone:410-224-8108
Mailing Address - Fax:443-481-1427
Practice Address - Street 1:4000 RIVER CRESCENT DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7721
Practice Address - Country:US
Practice Address - Phone:410-224-8108
Practice Address - Fax:443-481-1427
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR220625363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily