Michaeleen Kennedy Anderson, CRNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Middle River, MD
NPI 1083449334 · NPPES record last updated Sep 5, 2024
Key facts
- NPI
- 1083449334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- ACOO6878 (MD)
- Practice address
- 11560 Crossroads Cir Ste 102
Middle River, MD 21220-2885 - Phone
- (410) 508-0722
- NPI assigned
- Sep 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACOO6878 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | ACOO6878 | MD | Yes |
Addresses
Primary practice location
11560 Crossroads Cir Ste 102
Middle River, MD 21220-2885
Mailing address
11560 Crossroads Circle
Suite 102
Middle River, MD 21220-2885
Other providers in Middle River, MD
- Bernard Amalimeh
- Amazin Recovery Treatment Services
- Ambassadors Healthcare Services Inc.
- Americoast Maryland LLC
- Ameshicares Inc
- Candice Ann Angelilli
- Chisom Anyanwu
- Stella Aroh
- Payam Askary
- Assured Care Group
All providers in Middle River, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.