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NPI Code Detail

MEDICARE: KELLY BIRCH CRNP

MEDICARE: KELLY BIRCH CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerR165915MD

General Provider Information

NPI Number : 1922937648
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY BIRCH CRNP
Provider Business Mailing Address
First Line : 100 E CARROLL ST
Second Line :
City : SALISBURY
State : MD
Zip : 21801-5422
Country : US
Telephone Number : 410-546-6400
Fax Number :
Provider Business Practice Location Address
First Line : 100 E CARROLL ST
Second Line :
City : SALISBURY
State : MD
Zip : 21801-5422
Country : US
Telephone Number : 410-546-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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