Provider Demographics
NPI:1275347627
Name:KERSTETTER, MORGAN SHANAE (BA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SHANAE
Last Name:KERSTETTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 BANK ST APT 325
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2563
Mailing Address - Country:US
Mailing Address - Phone:814-933-8994
Mailing Address - Fax:
Practice Address - Street 1:4805 GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5695
Practice Address - Country:US
Practice Address - Phone:443-869-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker