SIMPLY 4 KIDZ HEALTHCARE LLC NPI 1699220731

NPI Information

  • NPI: 1699220731
  • Provider Name: SIMPLY 4 KIDZ HEALTHCARE, LLC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • CLIA Number: 21D2118096
  • Address: 265 MILL ST
    SUITE 800
    HAGERSTOWN, MD
    ZIP 21740
  • Phone: (240) 513-4595

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NPI Details

SIMPLY 4 KIDZ HEALTHCARE, LLC is a pediatrics nurse practitioner in Hagerstown, MD. SIMPLY 4 KIDZ HEALTHCARE, LLC NPI is 1699220731. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

265 MILL ST
SUITE 800
HAGERSTOWN, MD
ZIP 21740-130
Phone: (240) 513-4595
Fax: (240) 513-4596

The provider's authorized official is Teresa Marie Lum .
The authorized official title is Owner and has the following contact phone number (240) 513-4595.

The CLIA number assigned to this NPI record is 21D2118096 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/18/2016 and was last updated on 8/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsR109055MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1807602200MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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