Provider Demographics
NPI:1922842343
Name:HOAD, REBECCA CHARLES
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CHARLES
Last Name:HOAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2002 ROSECROFT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3255
Mailing Address - Country:US
Mailing Address - Phone:240-495-8832
Mailing Address - Fax:
Practice Address - Street 1:2002 ROSECROFT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-3255
Practice Address - Country:US
Practice Address - Phone:240-495-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNAOOOO81018376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide