Healthcare Provider Details

I. General information

NPI: 1932804622
Provider Name (Legal Business Name): MAUREEN ELIZABETH SUTHERLAND-WILLIAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 S COBB DR SE STE 800
SMYRNA GA
30080-4112
US

IV. Provider business mailing address

25 CROSSROADS DR STE 205
OWINGS MILLS MD
21117-5533
US

V. Phone/Fax

Practice location:
  • Phone: 470-604-4361
  • Fax: 800-339-9897
Mailing address:
  • Phone: 410-602-7792
  • Fax: 410-602-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP338636
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF11210806
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: