Individual
KIMBERLY MCILTROT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-9444
Mailing address
PO BOX 64563, BALTIMORE, MD 21264-4563
(410) 933-7440
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
ARNP9453359
FL
363L00000X
Nurse Practitioner
Primary
R115446
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020717600
—
FL
05
—
403693000
—
MD
Enumeration date
05/08/2006
Last updated
07/21/2022
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