Individual
KINSHASA D KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2131 DAVIDSONVILLE RD, CROFTON, MD 21114-1632
(410) 721-1000
Mailing address
4601 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-1131
(571) 249-3487
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C05240
MD
363A00000X
Physician Assistant
PA06008
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198312401
—
TX
01
—
8Y8981
BCBS
TX
Enumeration date
10/21/2008
Last updated
02/13/2024
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