Provider Demographics
NPI:1013386044
Name:KELLEY-DOBBS, KRISTEN ANNE (PA-C, MMS)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ANNE
Last Name:KELLEY-DOBBS
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:ANNE
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C, MMS
Mailing Address - Street 1:1305 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:GBMC - 6701 N CHARLES ST
Practice Address - Street 2:LABOR AND DELIVERY UNIT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:443-849-2597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005918363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant