Healthcare Provider Details

I. General information

NPI: 1598204372
Provider Name (Legal Business Name): KATHERINE HILL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY SUITE 150
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

201 DEFENSE HWY SUITE 100
ANNAPOLIS MD
21401-8943
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-1199
  • Fax: 443-481-1495
Mailing address:
  • Phone: 443-481-3354
  • Fax: 443-481-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR196661
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: