Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | R200901 | MD |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R200901 | MD |
NPI | 1013426824 |
---|---|
Provider Name | Dr. Blanche Cefora Kattie |
First Address | Elkridge, MD 21075-8803 |
Second Address | Pikesville, MD 21208-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 28/09/2021 |