Provider Demographics
NPI:1225182652
Name:LOSCHIAVO, KATHRYN SARAH (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SARAH
Last Name:LOSCHIAVO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1595 MARRIOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1301
Mailing Address - Country:US
Mailing Address - Phone:410-707-7827
Mailing Address - Fax:443-849-3182
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 4105
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-3184
Practice Address - Fax:443-849-3182
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR139326363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH330Medicare PIN