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General NPI Number Information
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NPI Number | 1205706124
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Entity Type | Individual
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Provider Name | MARTIE MCKENZIE VINSON
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Gender | Female
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2123 N CHARLES ST
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City | BALTIMORE
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State | MD
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Zip | 21218-5785
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Country | US
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Telephone | 443-313-6017
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Fax |
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Provider Business Mailing Address
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Address Line | 320 S HIGHLAND AVE APT 2
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City | BALTIMORE
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State | MD
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Zip | 21224-2372
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Country | US
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Telephone | 301-855-3988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM00051
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License Number State | MD
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