Individual
CHANELLE KIGGUNDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2950
(443) 527-8691
Mailing address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2950
(443) 527-8691
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R236692
MD
363LG0600X
Gerontology Nurse Practitioner
R236692
MD
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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