Healthcare Provider Details

I. General information

NPI: 1043018690
Provider Name (Legal Business Name): CHRISTINA KOWL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 AZALEA DR
ROCKVILLE MD
20850-2003
US

IV. Provider business mailing address

644 AZALEA DR
ROCKVILLE MD
20850-2003
US

V. Phone/Fax

Practice location:
  • Phone: 301-910-9171
  • Fax:
Mailing address:
  • Phone: 301-910-9171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR202205
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: