Kristin Andrea De Vries, RN

Individual provider Active NPI Registered Nurse · Hampstead, MD

NPI 1487997367 · NPPES record last updated Mar 29, 2013

Key facts

NPI
1487997367
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R192070 (MD)
Practice address
4222 Wolf Hill Dr
Hampstead, MD 21074-2009
Phone
(443) 744-1913
Fax
(443) 291-6680
NPI assigned
Mar 29, 2013
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R192070MDMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R192070 MD Yes

Addresses

Primary practice location

4222 Wolf Hill Dr
Hampstead, MD 21074-2009

Mailing address

4222 Wolf Hill Drive
Hampstead, MD 21074
Phone (443) 744-1913

Other identifiers

IdentifierTypeStateIssuer
R192070OtherMDMBON

Other providers in Hampstead, MD

All providers in Hampstead, MD · Registered Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.