Provider Demographics
NPI:1255520979
Name:CURTIS, CAROLYN (RN, CNM)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 16TH ST NW
Mailing Address - Street 2:#439
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-8300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 16TH ST NW
Practice Address - Street 2:#439
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-8300
Practice Address - Country:US
Practice Address - Phone:202-723-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN35625163W00000X, 367A00000X
MDR087263163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0450680Medicaid
DC0450680Medicaid