Provider Demographics
NPI:1598148660
Name:HOECK, CARLA RENEE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:RENEE
Last Name:HOECK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 MARIGOLD LN
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1668
Mailing Address - Country:US
Mailing Address - Phone:410-808-9127
Mailing Address - Fax:
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE 206
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4373
Practice Address - Country:US
Practice Address - Phone:410-238-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186034363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics