Healthcare Provider Details

I. General information

NPI: 1386213429
Provider Name (Legal Business Name): EUGENIA OHEMENG DEBRAH THORNE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OWINGS CT STE 14
REISTERSTOWN MD
21136-6433
US

IV. Provider business mailing address

100 OWINGS CT STE 14
REISTERSTOWN MD
21136-6433
US

V. Phone/Fax

Practice location:
  • Phone: 443-983-2866
  • Fax: 443-295-3343
Mailing address:
  • Phone: 443-983-2866
  • Fax: 443-295-3343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR179912
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: