Provider Demographics
NPI:1568064277
Name:WHEELER, KATHY ROBIN
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ROBIN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8517 GREENBELT RD APT 204
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2314
Mailing Address - Country:US
Mailing Address - Phone:240-354-1949
Mailing Address - Fax:
Practice Address - Street 1:4850 CONNECTICUT AVE NW APT 503
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5904
Practice Address - Country:US
Practice Address - Phone:202-210-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide