Provider Demographics
NPI:1629864079
Name:DICOCCO, KAREN (APRN/CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DICOCCO
Suffix:
Gender:F
Credentials:APRN/CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5629 COMPTON LN
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8867
Mailing Address - Country:US
Mailing Address - Phone:443-676-0912
Mailing Address - Fax:443-676-0912
Practice Address - Street 1:15005 SHADY GROVE RD STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6321
Practice Address - Country:US
Practice Address - Phone:855-940-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR220549363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health