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General NPI Number Information
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NPI Number | 1306655329
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Entity Type | Individual
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Provider Name | TONI LILLY RN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 6340 SECURITY BLVD STE 100B8
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City | GWYNN OAK
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State | MD
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Zip | 21207-5173
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Country | US
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Telephone | 443-804-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 832 CRYSTAL PALACE CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2256
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Country | US
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Telephone | 443-804-2294
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R213894
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License Number State | MD
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