Provider Demographics
NPI:1386899045
Name:THIER, MARY BETH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:THIER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:VAN BRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 GATEWAY DR
Mailing Address - Street 2:STE J
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4287
Mailing Address - Country:US
Mailing Address - Phone:410-638-7544
Mailing Address - Fax:
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:SUITE 206
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-638-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-22
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR158577363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care