Healthcare Provider Details
I. General information
NPI: 1164233029
Provider Name (Legal Business Name): ALONA KUZMENKO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1340 S DIVISION ST STE 301
SALISBURY MD
21804-7095
US
IV. Provider business mailing address
PO BOX 1978
SALISBURY MD
21802-1978
US
V. Phone/Fax
- Phone: 410-543-2060
- Fax: 410-543-2051
- Phone: 410-749-1015
- Fax: 410-749-0654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R238076 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: