Provider Demographics
NPI:1689619694
Name:HILGARTNER, KATHRYN S III (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
Last Name:HILGARTNER
Suffix:III
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 1:2002 MEDICAL PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-573-6480
Mailing Address - Fax:410-573-9413
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-723-5524
Practice Address - Fax:202-291-0512
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR145212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCD0361OtherRAILROAD MEDICARE GROUP
MD066MOtherMEDICARE GROUP
DC409629OtherMEDICARE GROUP