| Doctor Name: | MS. MARY GORDON WALTER |
| NPI Number: | 1023449642 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN/NP, PMHNP-BC |
| License Number: | RN2274139 |
| Business Practice Address: | 976 Solomans Island Road Prince Frederick, MD - 20678 |
| Business Phone Number: | 4105355400 |
| Business Fax Number: | |
| Mailing Address: | 975 Solomons Island Rd N, PRINCE FREDERICK |
| State: | MD |
| Postal Code: | 206783917 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2013 |
| NPI Last Update Date: | 09/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | RN2274139 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |