MEDICARE: MRS. EUGENIA OHEMENG DEBRAH THORNE FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R179912	MD

General Provider Information

NPI Number	:	1386213429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EUGENIA OHEMENG DEBRAH THORNE FNP-BC

Provider Business Mailing Address
First Line	:	100 OWINGS CT STE 14
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-6433
Country	:	US
Telephone Number	:	443-983-2866
Fax Number	:	443-295-3343

Provider Business Practice Location Address
First Line	:	100 OWINGS CT STE 14
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-6433
Country	:	US
Telephone Number	:	443-983-2866
Fax Number	:	443-295-3343

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	06/29/2026

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