Provider Demographics
NPI:1679299762
Name:BISSELL, KATHERINE (WHNP- BC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:BISSELL
Suffix:
Gender:F
Credentials:WHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 BLACKWELL RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6491
Mailing Address - Country:US
Mailing Address - Phone:301-318-8229
Mailing Address - Fax:
Practice Address - Street 1:9601 BLACKWELL RD STE 220
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6491
Practice Address - Country:US
Practice Address - Phone:301-318-8229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24192027363LX0001X
DC1051322163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE