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General NPI Number Information
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NPI Number | 1730894197
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Entity Type | Individual
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Provider Name | KRISTIE LYNN ECKERT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 301 ST PAUL ST MCAULEY SUITE 718
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City | BALTIMORE MD
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State | MD
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Zip | 21202-2165
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Country | US
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Telephone | 410-332-9356
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Fax | 410-659-1162
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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Fax | 410-500-4266
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R195409
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License Number State | MD
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