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General NPI Number Information
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NPI Number | 1518882935
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Entity Type | Individual
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Provider Name | KASAUNDRA MOORE
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 209 W FAYETTE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-3403
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Country | US
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Telephone | 410-605-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 GREENHEART LN
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City | EDGEWOOD
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State | MD
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Zip | 21040-2801
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Country | US
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Telephone | 443-354-0453
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R185293
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License Number State | MD
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