Provider Demographics
NPI:1932804622
Name:SUTHERLAND-WILLIAMS, MAUREEN ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:SUTHERLAND-WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CROSSROADS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5533
Mailing Address - Country:US
Mailing Address - Phone:410-602-7792
Mailing Address - Fax:410-602-9889
Practice Address - Street 1:25 CROSSROADS DR STE 205
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5533
Practice Address - Country:US
Practice Address - Phone:410-602-7792
Practice Address - Fax:443-575-4888
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF11210806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily