Individual
MARISSA ANN KENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6701 N CHARLES ST, BALTIMORE, MD 21204-6808
(443) 849-2000
Mailing address
511 E GITTINGS ST, BALTIMORE, MD 21230-4332
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06622
MD
Other
Enumeration date
10/13/2017
Last updated
02/28/2019
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