Provider Demographics
NPI:1366077133
Name:KILIKPO, YAH ROCHELLE (CRNP)
Entity type:Individual
Prefix:
First Name:YAH
Middle Name:ROCHELLE
Last Name:KILIKPO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1589 SULPHUR SPRING RD STE 109
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2542
Mailing Address - Country:US
Mailing Address - Phone:443-575-4880
Mailing Address - Fax:443-575-4891
Practice Address - Street 1:301 SAINT PAUL ST STE 605
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-332-1111
Practice Address - Fax:410-332-1752
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP021282363LF0000X
MDR255289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily