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General NPI Number Information
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NPI Number | 1538702907
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Entity Type | Organization
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Legal Business Name | KEY VITALITY SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 7718 BELAIR RD STE 200
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4062
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Country | US
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Telephone | 844-327-3747
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Fax | 844-327-3747
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Provider Business Mailing Address
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Address Line | 1130 CLOVER VALLEY WAY STE B
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City | EDGEWOOD
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State | MD
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Zip | 21040-2186
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Country | US
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Telephone | 443-506-3959
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Fax |
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Authorized Official
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Title or Position | CRNP
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Name | KEYSHA DONTREA REID-WEBB
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Credential | CRNP
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Telephone | 844-327-3747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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