| Doctor Name: | KERMIT MIDTHUN |
| NPI Number: | 1376785279 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.N. |
| License Number: | 667261 |
| Business Practice Address: | 4705 Harpers Ferry Rd Sharpsburg, MD - 217821608 |
| Business Phone Number: | 2405278118 |
| Business Fax Number: | |
| Mailing Address: | 4705 Harpers Ferry Rd, SHARPSBURG |
| State: | MD |
| Postal Code: | 217821608 |
| Phone Number: | 2405278118 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2009 |
| NPI Last Update Date: | 03/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 667261 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |