Individual
MRS. ELLIE F KAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-P
Contact information
Practice address
1708 W ROGERS AVE, BALTIMORE, MD 21209-4545
(410) 578-2617
Mailing address
1708 W ROGERS AVE, BALTIMORE, MD 21209-4545
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R164200
MD
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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