Provider Demographics
NPI:1417234626
Name:KELKAR, VANESSA LYNN (CRNA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:KELKAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7402 YORK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7532
Mailing Address - Country:US
Mailing Address - Phone:410-494-1846
Mailing Address - Fax:410-828-1706
Practice Address - Street 1:7402 YORK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7532
Practice Address - Country:US
Practice Address - Phone:410-494-1846
Practice Address - Fax:410-828-1706
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR139499207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology