Healthcare Provider Details

I. General information

NPI: 1497965727
Provider Name (Legal Business Name): CARING HANDS OF FREDRICK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 GREEN VALLEY RD
MONROVIA MD
21770-9517
US

IV. Provider business mailing address

4202 GREEN VALLEY RD
MONROVIA MD
21770-9517
US

V. Phone/Fax

Practice location:
  • Phone: 301-865-4484
  • Fax: 301-865-2844
Mailing address:
  • Phone: 301-865-4484
  • Fax: 301-865-2844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR050640
License Number StateMD

VIII. Authorized Official

Name: PAMELA JEAN EATON
Title or Position: OWNER
Credential: CRNP-MSN
Phone: 301-865-4484