Provider Demographics
NPI:1497973812
Name:RHINELANDER, NANCY CROCKER (LAC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CROCKER
Last Name:RHINELANDER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 MOUNTAIN RUN RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-6047
Mailing Address - Country:US
Mailing Address - Phone:304-258-5602
Mailing Address - Fax:
Practice Address - Street 1:355 WEST PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4871
Practice Address - Country:US
Practice Address - Phone:301-694-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLL00375171100000X
WV96164171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD523640OtherCAREFIRST BCBS