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Individual

ERNEST KEYAKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5718 HARFORD RD STE 103, BALTIMORE, MD 21214-2239
(513) 295-9807
Mailing address
15305 BEAUFORT PL, SILVER SPRING, MD 20905-4203
(513) 295-9807

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2019051520
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R208967
MD

Other

Enumeration date
11/29/2019
Last updated
03/29/2022
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