Basic Information
| Provider Information | |||||||||
| NPI: | 1447877279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRYAN | ||||||||
| FirstName: | KATHERINE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4092 OLIVE SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217589211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4044468711 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10175 LITTLE PATUXENT PKWY FL 6 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005610861 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2020 | ||||||||
| LastUpdateDate: | 04/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | R204077 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.