Provider Demographics
NPI:1184453789
Name:ERNST, KATHRYN VANSICKLE (DNP, IBCLC, RN)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:VANSICKLE
Last Name:ERNST
Suffix:
Gender:F
Credentials:DNP, IBCLC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6682 LOCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOCH HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1646
Mailing Address - Country:US
Mailing Address - Phone:410-530-2113
Mailing Address - Fax:
Practice Address - Street 1:345 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2123
Practice Address - Country:US
Practice Address - Phone:410-332-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207254163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care