Healthcare Provider Details

I. General information

NPI: 1871480079
Provider Name (Legal Business Name): ISABEL MAE KINTZLEY BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W LOMBARD ST
BALTIMORE MD
21201-1512
US

IV. Provider business mailing address

106 LOCKLEVEN DR
SEVERNA PARK MD
21146-4438
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-0501
  • Fax:
Mailing address:
  • Phone: 443-422-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR255978
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: