Individual
KEITH DIBENEDETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
11121 YORK RD, HUNT VALLEY, MD 21030-2006
(410) 628-2026
(410) 667-6834
Mailing address
11121 YORK RD, HUNT VALLEY, MD 21030-2006
(410) 628-2026
(410) 667-6834
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R210044
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
R210044
MD
Other
Enumeration date
09/18/2018
Last updated
11/14/2024
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