Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R184370 | MD |
N | 363LF0000X | Nurse Practitioner - Family Medicine | R184370 | MD |
NPI | 1013199587 |
---|---|
Provider Name | Terri Penna Kemmerer |
First Address | Baltimore, MD 21297-3086 |
Second Address | Frederick, MD 21701-4586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 24/05/2021 |