# KMH MEDICAL SERVICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487493367
- **Authorized official:** MRS. KELLY HEYWARD CRNP (CEO)
- **Authorized official phone:** (717) 577-2736

## Contact information

- **Practice address:** 5401 BELAIR RD, BALTIMORE, MD 21206-4265
- **Practice address phone:** (717) 577-2736
- **Mailing address:** 1637 COLD BOTTOM RD, SPARKS GLENCOE, MD 21152-9524
- **Mailing address phone:** (717) 577-2736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/21/2024
- **Last updated:** 05/21/2024