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General NPI Number Information
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NPI Number | 1568982940
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Entity Type | Individual
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Provider Name | GAYLE MARIE BLUM PMHNP-BC. FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 14707 OLD HANOVER RD
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City | BORING
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State | MD
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Zip | 21020-1000
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Country | US
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Telephone | 410-812-2342
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Fax |
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Provider Business Mailing Address
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Address Line | 15272 DOVER RD
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City | REISTERSTOWN
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State | MD
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Zip | 21136-3882
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Country | US
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Telephone | 410-812-2342
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R201227
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R201227
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License Number State | MD
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