Healthcare Provider Details

I. General information

NPI: 1528805876
Provider Name (Legal Business Name): MIST TOLER AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 COLESVILLE RD STE 1100
SILVER SPRING MD
20910-6346
US

IV. Provider business mailing address

909 RIDGEBROOK RD STE 300
SPARKS MD
21152-9477
US

V. Phone/Fax

Practice location:
  • Phone: 443-383-9300
  • Fax:
Mailing address:
  • Phone: 443-383-9300
  • Fax: 855-866-8710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR227001
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR227001
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: