Organization
KELLI K MCCALLUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI MCCALLUM CRNP (NURSE PRACTITIONER)
(443) 600-0105
Entity
Organization
Contact information
Practice address
3721 CHESMONT AVE, BALTIMORE, MD 21206-5041
(443) 600-0105
Mailing address
3721 CHESMONT AVE, BALTIMORE, MD 21206-5041
(443) 600-0105
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
R177915
MD
261QP2300X
Primary Care Clinic/Center
Primary
R177915
MD
Other
Enumeration date
08/05/2014
Last updated
01/07/2015
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