Provider Demographics
NPI:1841719366
Name:MCDEVITT, KATHRYN DOLORES (CNM)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DOLORES
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3715 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3004
Mailing Address - Country:US
Mailing Address - Phone:415-699-6903
Mailing Address - Fax:
Practice Address - Street 1:100 GALLATIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-7533
Practice Address - Country:US
Practice Address - Phone:844-796-2797
Practice Address - Fax:202-420-2903
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR227140367A00000X
DCRN1037464367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife