Individual
KIMLA RAYE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 MEDICAL PKWY, SUITE G50, ANNAPOLIS, MD 21401-7992
(410) 573-1094
(410) 573-1097
Mailing address
PO BOX 64935, BALTIMORE, MD 21264-4935
(443) 481-6569
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R161100
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009
BCBS
—
01
—
1396990
AETNA
—
01
—
315314
AMERIGROUP
—
05
—
410036100
—
MD
01
—
612176400
FEDERAL WORKMANS COMP
—
01
—
88913701
BCBS
—
Enumeration date
10/12/2006
Last updated
12/20/2011
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