Healthcare Provider Details

I. General information

NPI: 1902810591
Provider Name (Legal Business Name): KATHLEEN LORD FEROLI M.S.R.N.CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6345 WOODSIDE CT STE 102
COLUMBIA MD
21046-3224
US

IV. Provider business mailing address

802 MORRIS AVE
LUTHERVILLE MD
21093-4920
US

V. Phone/Fax

Practice location:
  • Phone: 410-381-5365
  • Fax: 410-381-9106
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberR050819
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: