Provider Demographics
NPI:1376081422
Name:REUSS, KRISTIN FREED (PMHNP-BC, AGAC-NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:FREED
Last Name:REUSS
Suffix:
Gender:F
Credentials:PMHNP-BC, AGAC-NP
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:GRACE ELIZBETH
Other - Last Name:FREED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-2704
Mailing Address - Fax:
Practice Address - Street 1:7 JAMES SPRING CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2949
Practice Address - Country:US
Practice Address - Phone:540-287-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174438363LP0808X
MDR253499363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health