Provider Demographics
NPI:1952171084
Name:KAVN HEALTH
Entity Type:Organization
Organization Name:KAVN HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWEGYIR-AFFUL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:443-636-0983
Mailing Address - Street 1:5850 WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1941
Mailing Address - Country:US
Mailing Address - Phone:443-953-8767
Mailing Address - Fax:410-480-7081
Practice Address - Street 1:5850 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1941
Practice Address - Country:US
Practice Address - Phone:443-953-8767
Practice Address - Fax:410-480-7081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty