Individual
MRS. KELLY COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, N5W40, BALTIMORE, MD 21201-1544
(410) 328-6749
(410) 328-7305
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-1340
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R165722
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311704900
—
MD
05
—
R165722
—
MD
Enumeration date
05/22/2012
Last updated
05/09/2023
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