Healthcare Provider Details

I. General information

NPI: 1184453367
Provider Name (Legal Business Name): KERI OHLHEISER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N WOLFE ST
BALTIMORE MD
21205-2110
US

IV. Provider business mailing address

406 S WOLFE ST
BALTIMORE MD
21231-2532
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-4766
  • Fax:
Mailing address:
  • Phone: 860-593-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1054545
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: