Individual provider · NPI-1

Kathryn Ann Blackford, CRNP

Nurse Practitioner, Gerontology · Catonsville, MD

NPI number1487609590
StatusActive
Last updated in NPPESFeb 8, 2011

Details

NPI
1487609590
Entity type
Individual (NPI-1)
Name
Kathryn Ann Blackford
Credential
CRNP
Sex
Female
Sole proprietor
No
Enumeration date
May 24, 2006
Last updated
Feb 8, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, GerontologyR047324MDYes

Practice location

711 Maiden Choice Ln
Catonsville, MD 21228-3632

Phone 410-247-5602 · Fax 410-242-1756

Mailing address

813 Maiden Choice Ln
Baltimore, MD 21228-3679

Phone 410-402-2258 · Fax 410-204-7279

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