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General NPI Number Information
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NPI Number | 1629040290
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Entity Type | Individual
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Provider Name | CAROLYN A STORCK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 202-444-8506
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Fax |
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Provider Business Mailing Address
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Address Line | 2325 N EARLY ST
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1705
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Country | US
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Telephone | 703-820-5690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 904983
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP08790
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 180954
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License Number State | NC
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