Individual
MRS. KRISTEN LEE SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2999
(410) 884-4888
Mailing address
5839 BRANDONS WAY, ELKRIDGE, MD 21075-7301
(703) 509-3529
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN199892
MD
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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