Provider Demographics
NPI:1073374815
Name:KINETIC PALLIATIVE GROUP
Entity type:Organization
Organization Name:KINETIC PALLIATIVE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-664-2880
Mailing Address - Street 1:9544 NEWBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4480
Mailing Address - Country:US
Mailing Address - Phone:951-760-1797
Mailing Address - Fax:855-945-2027
Practice Address - Street 1:9544 NEWBRIDGE DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4480
Practice Address - Country:US
Practice Address - Phone:951-760-1797
Practice Address - Fax:855-945-2027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty