Provider Demographics
NPI:1285525733
Name:PROCTOR, EILEEN (NREMTP)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:NREMTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-2009
Mailing Address - Country:US
Mailing Address - Phone:443-618-1766
Mailing Address - Fax:
Practice Address - Street 1:1790 FOREST DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4206
Practice Address - Country:US
Practice Address - Phone:410-263-7975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0125617146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic