| Kenah One Health Care Services, Llc | |
|
308 Crain Hwy N Glen Burnie MD 21061-3090 | |
| (443) 354-3989 | |
| (443) 288-4808 |
| Full Name | Kenah One Health Care Services, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 308 Crain Hwy N, Glen Burnie, Maryland |
| Authorized Official Name and Position | Kulvinder Singh Basra (OFFICE MANAGER) |
| Authorized Official Contact | 2409494886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenah One Health Care Services, Llc 308 Crain Hwy N Glen Burnie MD 21061-3090 Ph: (443) 354-3989 | Kenah One Health Care Services, Llc 308 Crain Hwy N Glen Burnie MD 21061-3090 Ph: (443) 354-3989 |
| NPI Number | 1790329530 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 10/14/2020 |
| Certification Date | 10/14/2020 |
| Medicare PECOS PAC ID | 5991135675 |
|---|---|
| Medicare Enrollment ID | O20200716003210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790329530 | NPI | - | NPPES |
| Provider Name | Ketty M Ngona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962714204 PECOS PAC ID: 3779756150 Enrollment ID: I20111031000430 |
| Provider Name | Latonya R Cotton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679877609 PECOS PAC ID: 1850511833 Enrollment ID: I20140926000551 |
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