Healthcare Provider Details

I. General information

NPI: 1285930560
Provider Name (Legal Business Name): MRS. NANCY ANN CHASE-TAUSCHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 HEMPSTEAD CT
JOPPA MD
21085-5429
US

IV. Provider business mailing address

1618 HEMPSTEAD CT
JOPPA MD
21085-5429
US

V. Phone/Fax

Practice location:
  • Phone: 410-679-3785
  • Fax:
Mailing address:
  • Phone: 410-679-3785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA2361
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: