Healthcare Provider Details

I. General information

NPI: 1164697819
Provider Name (Legal Business Name): MS. JANE J KIPCHIRCHIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1847 RITTER DR
WINDSOR MILL MD
21244-1875
US

IV. Provider business mailing address

5401 COLUMBIA RD APT.921
COLUMBIA MD
21044-5563
US

V. Phone/Fax

Practice location:
  • Phone: 410-919-7525
  • Fax:
Mailing address:
  • Phone: 443-413-2730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR207928
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: