Healthcare Provider Details

I. General information

NPI: 1790468049
Provider Name (Legal Business Name): KAITLIN MAETE SCHWINDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

19810 MOUTH OF MONOCACY RD
DICKERSON MD
20842-9500
US

V. Phone/Fax

Practice location:
  • Phone: 301-613-8898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR220029
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR220029
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: