Provider Demographics
NPI:1558729483
Name:CARELOCK, CATHERINE
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:CARELOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5740
Mailing Address - Country:US
Mailing Address - Phone:301-736-3237
Mailing Address - Fax:301-736-3237
Practice Address - Street 1:4008 CLARK ST
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5740
Practice Address - Country:US
Practice Address - Phone:301-736-3237
Practice Address - Fax:301-736-3237
Is Sole Proprietor?:No
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00009937163WH0200X
DCHHA11668163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA00379140Medicare Oscar/Certification