Provider Demographics
NPI:1003813072
Name:ZEREN, KIMBERLY LYN (CRNP- FAMILY)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LYN
Last Name:ZEREN
Suffix:
Gender:F
Credentials:CRNP- FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:410-338-3500
Mailing Address - Fax:
Practice Address - Street 1:45 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 109
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4425
Practice Address - Country:US
Practice Address - Phone:301-696-1011
Practice Address - Fax:301-696-1520
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR111875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily