Healthcare Provider Details

I. General information

NPI: 1033807433
Provider Name (Legal Business Name): KAREN LEE KEHRING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S CLINTON ST
BALTIMORE MD
21224-5730
US

IV. Provider business mailing address

1501 S CLINTON ST
BALTIMORE MD
21224-5730
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-2648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR169649
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: