Provider Demographics
NPI:1245837558
Name:ECKERL, CAROL LUREE (CDA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LUREE
Last Name:ECKERL
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4450
Mailing Address - Country:US
Mailing Address - Phone:443-790-5270
Mailing Address - Fax:
Practice Address - Street 1:673 CEDAR DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4450
Practice Address - Country:US
Practice Address - Phone:443-790-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program