Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 20000 | MD |
N | 2251H1200X | Hand | 20000 | MD |
NPI | 1295875979 |
---|---|
Provider Name | Dr. Heather D Nitsch |
First Address | Baltimore, MD 21220-2325 |
Second Address | Lutherville, MD 21093-5300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 22/06/2009 |