Individual
KIM MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3510 MADISON ST, HYATTSVILLE, MD 20782-3226
(301) 793-3309
Mailing address
3510 MADISON ST, HYATTSVILLE, MD 20782-3226
(301) 793-3309
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42802820500
—
MD
Enumeration date
03/16/2021
Last updated
03/16/2021
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