Provider Demographics
NPI:1124231071
Name:EUBANKS, NANCY CATHERINE (PT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CATHERINE
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10840 LITTLE PATUXENT PKWY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3115
Mailing Address - Country:US
Mailing Address - Phone:410-992-9753
Mailing Address - Fax:410-992-0268
Practice Address - Street 1:10840 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 402
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3115
Practice Address - Country:US
Practice Address - Phone:410-992-9753
Practice Address - Fax:410-992-0268
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist