Healthcare Provider Details

I. General information

NPI: 1689503815
Provider Name (Legal Business Name): JESSICA LYNN KAHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LANDING LN
ELKTON MD
21921-6704
US

IV. Provider business mailing address

118 SKYLINE DR
CONOWINGO MD
21918-1509
US

V. Phone/Fax

Practice location:
  • Phone: 410-996-5800
  • Fax:
Mailing address:
  • Phone: 717-545-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR238817
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: