Individual
MRS. AMANDA DIANE KALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
180 THOMAS JOHNSON DR STE 202, FREDERICK, MD 21702-4550
(301) 631-6877
(301) 631-5211
Mailing address
180 THOMAS JOHNSON DR STE 202, FREDERICK, MD 21702-4550
(301) 631-6877
(301) 631-2428
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R178408
MD
Other
Enumeration date
09/11/2014
Last updated
09/07/2022
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