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General NPI Number Information
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NPI Number | 1366647695
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Entity Type | Individual
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Provider Name | MARIA KIMBERLY VERDERAIME RVT, RN, DHERB
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6805 RUNKLES RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-7319
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Country | US
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Telephone | 301-703-9591
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Fax |
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Provider Business Mailing Address
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Address Line | 6805 RUNKLES RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-7319
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Country | US
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Telephone | 301-703-9591
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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