Healthcare Provider Details

I. General information

NPI: 1801513239
Provider Name (Legal Business Name): KATELYN NELL PARR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 12/26/2022
Certification Date: 12/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3064 WALDORF MARKET PL
WALDORF MD
20603-4871
US

IV. Provider business mailing address

10408 LIVINGSTON RD
FORT WASHINGTON MD
20744-4936
US

V. Phone/Fax

Practice location:
  • Phone: 855-910-3278
  • Fax:
Mailing address:
  • Phone: 804-335-6185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR246608
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024185886
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR246608
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: