Healthcare Provider Details

I. General information

NPI: 1568024008
Provider Name (Legal Business Name): CAREY MARTINEZ DELUCA FNP-C, AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-1214
US

IV. Provider business mailing address

341 PICEA VIEW CT
DERWOOD MD
20855-2580
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8000
  • Fax: 202-745-8231
Mailing address:
  • Phone: 410-804-8639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR197432
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR197432
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberR197432
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR197432
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: