Mrs Kathleen Jo Bautista, CRNP - Nurse Practitioner in Cambridge, MD

Mrs Kathleen Jo Bautista, CRNP is a Nurse Practitioner - Psychiatric/mental Health based in Cambridge, Maryland. Mrs Kathleen Jo Bautista is licensed to practice in Maryland (license number R069915) and her current practice location is 813-1 Chesapeake Drive, Cambridge, Maryland. She can be reached at her office (for appointments etc.) via phone at (410) 221-2266.

NPI number for Mrs Kathleen Jo Bautista is 1558483867 and her current mailing address is 813-1 Chesapeake Drive, Cambridge, Maryland. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558483867.

Contact Information

Mrs Kathleen Jo Bautista, CRNP
813-1 Chesapeake Drive,
Cambridge, MD 21613-9401
(410) 221-2266
(410) 221-2878

Map and Direction




Provider's Profile

Full NameMrs Kathleen Jo Bautista
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location813-1 Chesapeake Drive, Cambridge, Maryland
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1558483867
  • Provider Enumeration Date: 04/06/2007
  • Last Update Date: 05/24/2012

Medical Identifiers

Medical identifiers for Mrs Kathleen Jo Bautista such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558483867NPI-NPPES
499188OtherMDVO-MHA
609550002MedicaidMD
609550004MedicaidMD
479302100MedicaidMD
609550001MedicaidMD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health R069915 (Maryland)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kathleen Jo Bautista is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Kathleen Jo Bautista, CRNP
813-1 Chesapeake Drive,
Cambridge, MD 21613-9401

Ph: (410) 221-2266
Mrs Kathleen Jo Bautista, CRNP
813-1 Chesapeake Drive,
Cambridge, MD 21613-9401

Ph: (410) 221-2266

Reviews and Comments


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Phone: 410-221-7770    Fax: 410-221-7863
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