Healthcare Provider Details

I. General information

NPI: 1124642715
Provider Name (Legal Business Name): KYI WIN KYI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 W FAYETTE ST
BALTIMORE MD
21223-1938
US

IV. Provider business mailing address

7600 GEORGIA AVE NW STE 308
WASHINGTON DC
20012-1616
US

V. Phone/Fax

Practice location:
  • Phone: 410-727-3947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC006744
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1050360
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: