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Individual

KATHRYN ANDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, NREMT

Contact information

Practice address
9512 HARFORD RD, PARKVILLE, MD 21234-3100
(410) 882-3010
Mailing address
17400 BUSHLAND RD, PARKTON, MD 21120-9478
(443) 966-0349

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
1852246
MD
2255A2300X
Athletic Trainer
Primary
A0000962
MD

Other

Enumeration date
03/04/2019
Last updated
03/04/2019
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