Provider Demographics
NPI:1235488586
Name:KEISWETTER, SESA (MS RN)
Entity Type:Individual
Prefix:MR
First Name:SESA
Middle Name:
Last Name:KEISWETTER
Suffix:
Gender:M
Credentials:MS RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 YORK RD 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2130
Mailing Address - Country:US
Mailing Address - Phone:410-887-2313
Mailing Address - Fax:410-377-9687
Practice Address - Street 1:6401 YORK RD 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21212-2130
Practice Address - Country:US
Practice Address - Phone:410-887-2313
Practice Address - Fax:410-377-9687
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189308163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management