Kathleen Elizabeth Dudley, RN, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R174386 Issued in MD

Practice address

120 Sister Pierre Dr Ste 407
Towson, MD 21204-7536

Phone

(410) 769-8801

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment
• Nardine Assaad, MD, LLC

  • Pediatrics Physician
  • Towson, MD
  • NPI 1154955862
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1124574710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 407",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 407",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536",
            "telephone_number": "410-769-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Broadway",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173312503",
            "country_code": "US",
            "telephone_number": "717-632-3911",
            "fax_number": "717-632-1224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "credential": "RN, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP016535",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R174386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dubin (Bend Chiropractic)
• Wendy L Dubin, M.D.
• Rebecca Yael Duclos, LCSW-C
• Akshay Duddu
• Justin Matthew Dudley, MSN, AGACNP-BC, CCRN
• Barbara E Duffy, CRNP-PMH
• Nicole Marie Dugan, CPNP
• Scott Charles Dugas, CRNA
• Tracy E Duke, MD
• Dulaney Eye Institute, LLC

• Pediatric Nurse Practitioner in Towson, MD
• Providers in Towson, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.