Provider Demographics
NPI:1003243270
Name:KEBECK, ERIKA THERESE (DONA)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:THERESE
Last Name:KEBECK
Suffix:
Gender:F
Credentials:DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8044 SAVAGE GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9674
Mailing Address - Country:US
Mailing Address - Phone:443-275-3802
Mailing Address - Fax:301-470-2832
Practice Address - Street 1:8044 SAVAGE GUILFORD RD
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9674
Practice Address - Country:US
Practice Address - Phone:443-275-3802
Practice Address - Fax:301-470-2832
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula