Individual
EVITA KVISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7550 TEAGUE RD STE 500, HANOVER, MD 21076-1945
(410) 412-3964
Mailing address
2631 MIDWAY BRANCH DR APT 201, ODENTON, MD 21113-4107
(949) 456-1893
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
65119
ID
363LG0600X
Gerontology Nurse Practitioner
Primary
R275992
MD
Other
Enumeration date
03/25/2021
Last updated
04/28/2026
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