Provider Demographics
NPI:1023031697
Name:PRATT, KARI (ARNP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:87 THOMAS JOHNSON DR
Mailing Address - Street 2:STE 101
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4427
Mailing Address - Country:US
Mailing Address - Phone:301-694-0606
Mailing Address - Fax:301-662-6928
Practice Address - Street 1:87 THOMAS JOHNSON DR
Practice Address - Street 2:STE 101
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4427
Practice Address - Country:US
Practice Address - Phone:301-694-0606
Practice Address - Fax:301-662-6928
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000662363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307535400Medicaid