Provider Demographics
NPI:1588955637
Name:HOUCK, PATRICIA MARY (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARY
Last Name:HOUCK
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16948 RIVERS REACH LANE
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20637
Mailing Address - Country:US
Mailing Address - Phone:301-274-3360
Mailing Address - Fax:
Practice Address - Street 1:16948 RIVERS REACH LN
Practice Address - Street 2:
Practice Address - City:HUGHESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20637-2818
Practice Address - Country:US
Practice Address - Phone:301-274-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR123527163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse