Provider Demographics
NPI:1790269223
Name:KEHLA, NORA-CLAIRE S
Entity Type:Individual
Prefix:
First Name:NORA-CLAIRE
Middle Name:S
Last Name:KEHLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10509 CAMPUS WAY S
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1308
Mailing Address - Country:US
Mailing Address - Phone:301-892-1867
Mailing Address - Fax:
Practice Address - Street 1:1906 FOX ST APT 201
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-2359
Practice Address - Country:US
Practice Address - Phone:301-892-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13970374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide