Individual
KATELYN HEBEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
120 SISTER PIERRE DR STE 403, TOWSON, MD 21204-7536
(410) 823-6408
Mailing address
120 SISTER PIERRE DR STE 403, TOWSON, MD 21204-7536
(410) 823-6408
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0006186
MD
363A00000X
Physician Assistant
MA059007
PA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0006186
MARYLAND BOARD OF HEALTH
MD
Enumeration date
07/20/2016
Last updated
01/27/2022
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