Healthcare Provider Details

I. General information

NPI: 1013089010
Provider Name (Legal Business Name): KEBA MARIA ARMSTRONG CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEBA TROTMAN

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 LOCH RAVEN BLVD
BALTIMORE MD
21218-2108
US

IV. Provider business mailing address

3900 LOCH RAVEN BLVD
BALTIMORE MD
21218-2108
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7620
  • Fax: 410-209-8418
Mailing address:
  • Phone: 410-605-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR152824
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: