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Individual

KISHMA K STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
6622B RITCHIE HWY, GLEN BURNIE, MD 21061-2317
(413) 912-5437
Mailing address
6622B RITCHIE HWY, GLEN BURNIE, MD 21061-2317
(240) 330-0146

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R202637
MD

Other

Enumeration date
08/02/2022
Last updated
08/02/2022
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