Provider Demographics
NPI:1447738661
Name:JANISZEWSKI, KRISTEN (CNM)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:JANISZEWSKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 GUILFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4612
Mailing Address - Country:US
Mailing Address - Phone:678-733-0079
Mailing Address - Fax:
Practice Address - Street 1:7300 YORK RD STE 201
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7608
Practice Address - Country:US
Practice Address - Phone:410-427-5472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife