Provider Demographics
NPI:1003801697
Name:PROTZMAN, NAYDA (MSW)
Entity Type:Individual
Prefix:MS
First Name:NAYDA
Middle Name:
Last Name:PROTZMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43D MDG/SGOHA
Mailing Address - Street 2:829 ARMISTEAD ST
Mailing Address - City:POPE AFB
Mailing Address - State:NC
Mailing Address - Zip Code:28308-2383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43D MDG/SGOHA
Practice Address - Street 2:829 ARMISTEAD ST
Practice Address - City:POPE AFB
Practice Address - State:NC
Practice Address - Zip Code:28308-2383
Practice Address - Country:US
Practice Address - Phone:910-394-4700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW00000059621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical