Provider Demographics
NPI:1508381260
Name:HAUPTMAN, ELISSA GERFEN (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:GERFEN
Last Name:HAUPTMAN
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ELIZABETH
Other - Last Name:GERFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4520 E WEST HWY STE 775
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-0066
Mailing Address - Country:US
Mailing Address - Phone:240-531-2799
Mailing Address - Fax:240-531-2802
Practice Address - Street 1:4520 E WEST HWY STE 775
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3319
Practice Address - Country:US
Practice Address - Phone:240-531-2799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002370363LP0808X
DCNP1030238363LP0808X
VA0024175088363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health