1740465251 NPI number — MRS. KATHRYN ELAINE BARAN ACNP

Table of content: MEGHAN PENNINGTON APRN (NPI 1093253056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740465251 NPI number — MRS. KATHRYN ELAINE BARAN ACNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARAN
Provider First Name:
KATHRYN
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SWANSON
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
ELAINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ACNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740465251
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 N KENWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21224-1241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-277-2841
Provider Business Mailing Address Fax Number:
410-550-0816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4940 EASTERN AVE
Provider Second Line Business Practice Location Address:
WOUND HEALING CENTER
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224-2735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-550-0315
Provider Business Practice Location Address Fax Number:
410-550-0816
Provider Enumeration Date:
01/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  AC000428 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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