Individual
ELLEN L. KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6598
(410) 328-3577
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-6598
(410) 328-3577
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R145838
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404708700
—
MD
01
—
640729-01
BC/BS
MD
Enumeration date
05/23/2006
Last updated
02/01/2012
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