Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathleen O Demutis, CRNP

Individual provider Nurse Practitioner · NPI 1184638918

Kathleen O Demutis, CRNP is a Nurse Practitioner in Paoli, Pennsylvania. Qualified in 1997, 29 years ago. Practices with Main Line Healthcare, a 1,153-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
29
Licensed in
PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

255 W Lancaster Ave Ste 330
Paoli, PA 19301-1766
Phone: (610) 786-3200
Fax: (610) 786-3208
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence VP004650C (PA)
Nurse Practitioner Taxonomy 363L00000X · Licence VP004650C (PA)

Record details

NPI number1184638918
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJuly 28, 2006
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Main Line Healthcare — 1153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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