Provider Demographics
NPI:1174013411
Name:OPEL, KATRINA ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:ANN
Last Name:OPEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MAIN ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:WESTERNPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21562-1400
Mailing Address - Country:US
Mailing Address - Phone:301-359-5145
Mailing Address - Fax:
Practice Address - Street 1:51 MAIN ST STE 4A
Practice Address - Street 2:
Practice Address - City:WESTERNPORT
Practice Address - State:MD
Practice Address - Zip Code:21562-1400
Practice Address - Country:US
Practice Address - Phone:301-359-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily