Provider Demographics
NPI:1013040872
Name:KLOCH, KATHLEEN E (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:KLOCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 ADY RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-1707
Mailing Address - Country:US
Mailing Address - Phone:410-838-0151
Mailing Address - Fax:
Practice Address - Street 1:119 S HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3644
Practice Address - Country:US
Practice Address - Phone:410-838-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR051033163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health