Healthcare Provider Details

I. General information

NPI: 1598698995
Provider Name (Legal Business Name): KIMBERLY WARREN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 PISCATAWAY RD STE 410
CLINTON MD
20735-2555
US

IV. Provider business mailing address

9135 PISCATAWAY RD STE 410
CLINTON MD
20735-2555
US

V. Phone/Fax

Practice location:
  • Phone: 240-253-3898
  • Fax: 833-222-4288
Mailing address:
  • Phone: 240-253-3898
  • Fax: 833-222-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: