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General NPI Number Information
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NPI Number | 1164040200
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Entity Type | Organization
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Legal Business Name | SRKITE ASSOCIATES
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 8 SUDBROOK LN STE 1A
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City | PIKESVILLE
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State | MD
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Zip | 21208-4132
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Country | US
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Telephone | 443-405-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 9532 BRANCHLEIGH RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2000
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Country | US
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Telephone | 443-204-2421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SAMANTHA ROBERTA KITE
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Credential | NP
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Telephone | 443-204-2421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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