Mary Kathryn Proctor, CRNP
Nurse Practitioner, Family in Clinton, MD. Individual provider (NPI-1).
NPI number1144779158
StatusActive
Last updated in NPPESOct 12, 2016
Details
- NPI
- 1144779158
- Entity type
- Individual (NPI-1)
- Name
- Ms. Mary Kathryn Proctor
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2016
- Last updated
- Oct 12, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R140050 | MD | Yes |
| 163W00000X | Registered Nurse | R140050 | MD |
Practice location
9135 Piscataway RdSuite 420
Clinton, MD 20735-2549
Phone 301-868-2555
Mailing address
9135 Piscataway RdSuite 420
Clinton, MD 20735-2549
Phone 301-868-2555
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