MEDICARE: MARIA DIAS RAYNAL APRN MS BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	R106890	MD

General Provider Information

NPI Number	:	1871765313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DIAS RAYNAL APRN MS BC

Provider Business Mailing Address
First Line	:	5805 SPRINGFIELD DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20816-1235
Country	:	US
Telephone Number	:	301-320-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	5805 SPRINGFIELD DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20816-1235
Country	:	US
Telephone Number	:	301-320-2656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	12/11/2012

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