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NPI Code Detail

MEDICARE: MS. KATHLEEN ANN LUTON CRNP

MEDICARE: MS. KATHLEEN ANN LUTON CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerR076014MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112431283OTHERCAQH

General Provider Information

NPI Number : 1194852699
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN ANN LUTON CRNP
Provider Business Mailing Address
First Line : 9520 JEANNE CT
Second Line :
City : LAUREL
State : MD
Zip : 20723-5924
Country : US
Telephone Number : 240-508-8522
Fax Number :
Provider Business Practice Location Address
First Line : 9309 OLD GEORGETOWN RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-1620
Country : US
Telephone Number : 301-841-0835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 03/29/2013

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