Provider Demographics
NPI:1053619346
Name:ELCOCK, NAOMI E (RN)
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:E
Last Name:ELCOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 MOUNT OAK RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1246
Mailing Address - Country:US
Mailing Address - Phone:301-613-0110
Mailing Address - Fax:410-523-0202
Practice Address - Street 1:15400 MOUNT OAK RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1246
Practice Address - Country:US
Practice Address - Phone:310-613-0110
Practice Address - Fax:301-390-2549
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR075339163W00000X, 163WA2000X, 163WC0400X, 163WC1600X, 163WG0000X, 163WH0500X, 163WH1000X, 163WW0000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WW0000XNursing Service ProvidersRegistered NurseWound Care