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NPI Code Detail

MEDICARE: KELLIE LE DNP, CPNP-PC

MEDICARE: KELLIE LE DNP, CPNP-PC
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
1363LP0200XPediatric Nurse PractitionerR231783MD

General Provider Information

NPI Number : 1952132813
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE LE DNP, CPNP-PC
Provider Business Mailing Address
First Line : 9306 GEORGIA BELLE DR
Second Line :
City : PERRY HALL
State : MD
Zip : 21128-8816
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11055 LITTLE PATUXENT PKWY STE 103
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-2908
Country : US
Telephone Number : 410-992-9339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2024
Last Update Date : 08/12/2024

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