Individual
KANITRA MYREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5312 LUDLOW DR, TEMPLE HILLS, MD 20748-2125
(301) 423-2850
Mailing address
5312 LUDLOW DR, TEMPLE HILLS, MD 20748-2125
(301) 423-2850
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R136312
MD
Other
Enumeration date
09/03/2015
Last updated
10/20/2015
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