Provider Demographics
NPI:1992067599
Name:CUTCHEMBER, VICTORIA MARIE (GMA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:CUTCHEMBER
Suffix:
Gender:F
Credentials:GMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45910 FOXCHASE DR
Mailing Address - Street 2:APT.315
Mailing Address - City:GREAT MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20634-2381
Mailing Address - Country:US
Mailing Address - Phone:240-434-6477
Mailing Address - Fax:
Practice Address - Street 1:45910 FOXCHASE DR
Practice Address - Street 2:APT.315
Practice Address - City:GREAT MILLS
Practice Address - State:MD
Practice Address - Zip Code:20634-2381
Practice Address - Country:US
Practice Address - Phone:240-434-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00031208376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide