Provider Demographics
NPI:1760746341
Name:WIRLEN, KENNETH (HHA)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:WIRLEN
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 ARTESIAN LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3802
Mailing Address - Country:US
Mailing Address - Phone:301-613-3463
Mailing Address - Fax:
Practice Address - Street 1:2420 ARTESIAN LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3802
Practice Address - Country:US
Practice Address - Phone:301-613-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No374U00000XNursing Service Related ProvidersHome Health Aide