Individual
KATHRYN ANN BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
711 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-3632
(410) 247-5602
(410) 242-1756
Mailing address
813 MAIDEN CHOICE LN, BALTIMORE, MD 21228-3679
(410) 402-2258
(410) 204-7279
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R047324
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0943ER-892821-02
CAREFIRST BCBS OF MD
—
01
—
522096682
TRICARE
—
01
—
8304927
EVERCARE
—
01
—
89282101
BCBS
—
05
—
960702100
—
MD
01
—
KG01ER-892821-01
CAREFIRST BCBS OF MD
—
01
—
T016-000052
BCBS-DC
—
Enumeration date
05/24/2006
Last updated
02/08/2011
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