Basic Information
Provider Information
NPI: 1598245946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAPOLI
FirstName: KATHLEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5022 CAMPBELL BLVD STE BC
Address2:  
City: NOTTINGHAM
State: MD
PostalCode: 212364969
CountryCode: US
TelephoneNumber: 4108703808
FaxNumber:  
Practice Location
Address1: 5022 CAMPBELL BLVD APT B-C
Address2:  
City: NOTTINGHAM
State: MD
PostalCode: 212364969
CountryCode: US
TelephoneNumber: 4108703808
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2018
LastUpdateDate: 09/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3012602KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home