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General NPI Number Information
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NPI Number | 1992680243
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Entity Type | Individual
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Provider Name | OLYMPIA CHAGOURIS ROSS MSN, ACM, WCCM, RN
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Gender | Female
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 32550 DOCS PL UNIT 2
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City | MILLVILLE
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State | DE
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Zip | 19967-6975
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Country | US
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Telephone | 302-539-4302
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Fax |
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Provider Business Mailing Address
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Address Line | 27 W MC CABE ST
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City | SELBYVILLE
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State | DE
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Zip | 19975-9316
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Country | US
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Telephone | 410-215-8002
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Fax |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | L1-0073482
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | L1-0073482
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | L1-0073482
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License Number State | DE
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