Individual
RYAN KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 W HIGH ST, SUITE 314, ELKTON, MD 21921-5529
(410) 620-0545
Mailing address
210 CHESAPEAKE BLVD, ELKTON, MD 21921-6395
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AC001389
MD
Other
Enumeration date
04/28/2014
Last updated
09/10/2014
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