Provider Demographics
NPI:1972488914
Name:MANROSS, PAULYNN (MSCN)
Entity type:Individual
Prefix:MRS
First Name:PAULYNN
Middle Name:
Last Name:MANROSS
Suffix:
Gender:F
Credentials:MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 GRAYSTONE FARM RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-9101
Mailing Address - Country:US
Mailing Address - Phone:443-903-6162
Mailing Address - Fax:
Practice Address - Street 1:109 GRAYSTONE FARM RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-9101
Practice Address - Country:US
Practice Address - Phone:443-903-6162
Practice Address - Fax:443-903-6162
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist