Provider Demographics
NPI:1013426824
Name:KATTIE, BLANCHE CEFORA (DNP, FNP-BC, PMHNP)
Entity type:Individual
Prefix:DR
First Name:BLANCHE
Middle Name:CEFORA
Last Name:KATTIE
Suffix:
Gender:F
Credentials:DNP, FNP-BC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 CHARTER DR STE 430
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2870
Mailing Address - Country:US
Mailing Address - Phone:301-259-3574
Mailing Address - Fax:301-235-1556
Practice Address - Street 1:4000 OLD COURT RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2800
Practice Address - Country:US
Practice Address - Phone:443-898-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200901363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily