Individual provider · Type 1 NPI

Kenny Gaston

Student in an Organized Health Care Education/Training Program · Mitchellville, MD

NPI number 1205302973 Active

Practice location

12158 Central Ave
Mitchellville, MD 20721-1932

Call (301) 430-2750 Map

Mailing address

1306 Twig Ter
Silver Spring, MD 20905-7038

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1205302973

Kenny Gaston's National Provider Identifier is 1205302973, issued on Oct 19, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mitchellville, MD. The record was last updated on Oct 19, 2018.