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NPI 1508381260

NPI 1508381260 : ELISSA GERFEN HAUPTMAN DNP, CRNP, PMHNP-BC : CHEVY CHASE, MD

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General NPI Number Information
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    NPI Number           |    1508381260
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    Entity Type          |    Individual 
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    Provider Name        |    ELISSA GERFEN HAUPTMAN DNP, CRNP, PMHNP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/03/2017
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    Last Update Date     |    10/07/2024
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Provider Practice Location Address
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    Address Line         |    5454 WISCONSIN AVE STE 1275 
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    City                 |    CHEVY CHASE
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    State                |    MD
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    Zip                  |    20815-6933
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    Country              |    US
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    Telephone            |    240-743-4535
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    Fax                  |    240-483-0862
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Provider Business Mailing Address
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    Address Line         |    5454 WISCONSIN AVE STE 1275 
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    City                 |    CHEVY CHASE
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    State                |    MD
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    Zip                  |    20815-6933
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    Country              |    US
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    Telephone            |    240-743-4535
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    Fax                  |    240-483-0862
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    NP1030238
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    License Number State |    DC
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    0024175088
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    License Number State |    VA
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Taxonomy #3
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    R217962
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    License Number State |    MD
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