Healthcare Provider Details

I. General information

NPI: 1750183224
Provider Name (Legal Business Name): KATIE LOUISE HELLSTERN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 W PULASKI HWY
ELKTON MD
21921-4714
US

IV. Provider business mailing address

953 W PULASKI HWY
ELKTON MD
21921-4714
US

V. Phone/Fax

Practice location:
  • Phone: 443-485-6544
  • Fax: 443-485-6442
Mailing address:
  • Phone: 443-485-6544
  • Fax: 443-485-6442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP55176
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: