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General NPI Number Information
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NPI Number | 1740763093
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Entity Type | Individual
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Provider Name | KATTIE KHADAR DNP, CRNP-FAMILY
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Gender | Female
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVENUE
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 301-319-8809
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Fax |
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Provider Business Mailing Address
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Address Line | 11212 BROAD GREEN DRIVE
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City | POTOMAC
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State | MD
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Zip | 20854
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Country | US
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Telephone | 240-481-5289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R139841
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License Number State | MD
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