Provider Demographics
NPI:1023871167
Name:STOECKER, CARLOTTA
Entity type:Individual
Prefix:
First Name:CARLOTTA
Middle Name:
Last Name:STOECKER
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 1:251 LUCKY BOTTOM DR
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-5828
Mailing Address - Country:US
Mailing Address - Phone:240-452-6081
Mailing Address - Fax:
Practice Address - Street 1:251 LUCKY BOTTOM DR
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-5828
Practice Address - Country:US
Practice Address - Phone:240-452-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker