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NPI Code Detail

MEDICARE: MS. KATHLEEN MCCLANAHAN CRNP

MEDICARE: MS. KATHLEEN MCCLANAHAN CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN63775DC
2363L00000XNurse PractitionerR128846MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275503633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN MCCLANAHAN CRNP
Provider Business Mailing Address
First Line : 24035 THREE NOTCH RD
Second Line :
City : HOLLYWOOD
State : MD
Zip : 20636-4871
Country : US
Telephone Number : 301-373-7900
Fax Number : 301-373-6900
Provider Business Practice Location Address
First Line : 24035 THREE NOTCH RD
Second Line :
City : HOLLYWOOD
State : MD
Zip : 20636-4871
Country : US
Telephone Number : 301-373-7900
Fax Number : 301-373-6900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 12/10/2021

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