Individual
MRS. KEISHA R. CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 GRANADA ST, ACCOKEEK, MD 20607-3026
(301) 203-6462
(301) 203-0317
Mailing address
1200 GRANADA ST, ACCOKEEK, MD 20607-3026
(301) 203-6462
(301) 203-0317
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R168546
MD
Other
Enumeration date
12/04/2009
Last updated
04/27/2012
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