MEDICARE: MS. KATHERINE MARY KEMPER-DEAN 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
1	363LA2200X	Adult Health Nurse Practitioner	R089866	MD
2	363LG0600X	Gerontology Nurse Practitioner	R089866	MD

General Provider Information

NPI Number	:	1376863837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE MARY KEMPER-DEAN CRNP

Provider Business Mailing Address
First Line	:	9908 DALLAS AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-2237
Country	:	US
Telephone Number	:	301-593-1443
Fax Number	:

Provider Business Practice Location Address
First Line	:	18121 GEORGIA AVE
Second Line	:	SUITE 103
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	301-933-5050
Fax Number	:	301-949-3262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	06/08/2010

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