Clemens, Kristin Marie

Clemens, Kristin Marie is an sole proprietor health care provider with primary practice located at 800 S Frederick Ave Ste 200A , Gaithersburg MD 20877-4152. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Clemens, Kristin Marie can be contacted via phone (877) 588-0282.

Contact Information

Primary practice address
800 S Frederick Ave Ste 200A Gaithersburg MD 20877-4152
Phone: (877) 588-0282
Fax: (301) 880-0228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AC003082 Maryland

Profile Details

NPI number 1154961381
LBN Legal business name Clemens, Kristin Marie
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2020
Last updated May 4th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154961381 NPPES
Maryland MEDICAID 100148709

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