Mariesa Kinch, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R127505 Issued in MD

Practice address

12070 Old Line Ctr
Ste 207
Waldorf, MD 20602-2567

Phone

(301) 870-0660

Fax

(301) 932-8310

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Calvert Health Ventures Inc

  • Internal Medicine Physician
  • Prince Frederick, MD
  • NPI 1275559312
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1780681668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "STE 207",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022567",
            "telephone_number": "301-870-0660",
            "fax_number": "301-932-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "STE 207",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022567",
            "telephone_number": "301-870-0660",
            "fax_number": "301-932-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCH",
        "first_name": "MARIESA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R127505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephvon D Keys
• Mohammed S Khalid, M.D.
• Nimesh Khatri, M.D.
• Laura Kijewski, BSW, LSWA
• Sarah Kimball, PNP
• Kindred Services, Inc.
• King Oral Surgery Group
• Deidre Cheryl King-Woodward
• Beata Kinsey, LCPC
• Marian E. Kirk, P.T.

• Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.