Provider Demographics
NPI:1588901193
Name:BOZEK, KATHRYN BARKSDALE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:BARKSDALE
Last Name:BOZEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:H
Other - Last Name:BARKSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37215
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3215
Mailing Address - Country:US
Mailing Address - Phone:615-944-8114
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:WEST WING, 1.5, SUITE 400
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:615-944-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1027648363LP0200X
VA0024170522363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics