| NPI | 1629732805 |
|---|---|
| Doing Business As | JHU - FREDERICK NICU |
| Entity Type | Organization |
| Authorized Contact | SHAVONDA L KEATING Director Of Provider Enrollment 410-933-6430 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |