Healthcare Provider Details

I. General information

NPI: 1528366382
Provider Name (Legal Business Name): MS. CAROLINE ANNE PIRTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE ANNE HARRIS

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1434 PORTER ST
FREDERICK MD
21702-9254
US

IV. Provider business mailing address

47 WHISKERS WAY
RANSON WV
25438-4870
US

V. Phone/Fax

Practice location:
  • Phone: 301-619-4052
  • Fax:
Mailing address:
  • Phone: 304-350-7884
  • Fax: 301-846-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02649
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101002043
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: