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General NPI Number Information
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NPI Number | 1528761897
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Entity Type | Organization
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Legal Business Name | KINETIC PRIMARY CARE
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 9544 NEWBRIDGE DR
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City | POTOMAC
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State | MD
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Zip | 20854-4480
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Country | US
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Telephone | 804-742-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 9544 NEWBRIDGE DR
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City | POTOMAC
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State | MD
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Zip | 20854-4480
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Country | US
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Telephone | 804-742-2613
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNA NORWOOD
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Credential | CRNP
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Telephone | 703-485-5689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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