Healthcare Provider Details

I. General information

NPI: 1871351890
Provider Name (Legal Business Name): KESSLER FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CUMBERLAND ST
CLEAR SPRING MD
21722-1973
US

IV. Provider business mailing address

PO BOX 231
CLEAR SPRING MD
21722-0231
US

V. Phone/Fax

Practice location:
  • Phone: 240-835-5770
  • Fax: 240-850-4028
Mailing address:
  • Phone: 240-835-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN KESSLER
Title or Position: OWNER
Credential:
Phone: 240-835-5770