Provider Demographics
NPI:1174871040
Name:SUTHERLAND, KARLI TALBOTT (FNP)
Entity type:Individual
Prefix:MRS
First Name:KARLI
Middle Name:TALBOTT
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 ALPINE CT
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20689-9607
Mailing Address - Country:US
Mailing Address - Phone:410-257-5146
Mailing Address - Fax:
Practice Address - Street 1:2601 RIVA RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7304
Practice Address - Country:US
Practice Address - Phone:410-571-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily