Individual
KELLY ALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11870 OAK MANOR DR, WALDORF, MD 20601-8638
(301) 542-5466
Mailing address
11870 OAK MANOR DR, WALDORF, MD 20601-8638
(301) 542-5466
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00074516
MD
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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