Provider Demographics
NPI:1639123474
Name:PAPATHAKIS, KATIE R (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:R
Last Name:PAPATHAKIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:R
Other - Last Name:LAMBROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:9103 FRANKLIN SQUARE DR
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3900
Mailing Address - Country:US
Mailing Address - Phone:443-777-7895
Mailing Address - Fax:443-777-8027
Practice Address - Street 1:9103 FRANKLIN SQUARE DR
Practice Address - Street 2:SUITE 1400
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3900
Practice Address - Country:US
Practice Address - Phone:443-777-7895
Practice Address - Fax:443-777-8027
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149963363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health