Provider Demographics
NPI:1538434840
Name:DOSS, KRISTINA ANN (CNM)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANN
Last Name:DOSS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6701 N CHARLES ST DEPT OF L & D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:443-849-2577
Mailing Address - Fax:443-849-3026
Practice Address - Street 1:6701 N CHARLES STREET
Practice Address - Street 2:DEPT OF LABOR & DELIVERY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-2577
Practice Address - Fax:443-849-3026
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157219367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777580601Medicaid