Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024166682 | VA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AC000258 | MD |
NPI | 1033228143 |
---|---|
Provider Name | Naomi Klein |
First Address | Columbia, MD 21046-1722 |
Second Address | Columbia, MD 21046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 16/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0084 | CAREFIRST (01) | DC |
600314 | VALUE OPTIONS (01) |