Provider Demographics
NPI:1912017609
Name:ATCHINSON, NIELSEN (PT)
Entity Type:Individual
Prefix:
First Name:NIELSEN
Middle Name:
Last Name:ATCHINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 GETTYSBURG RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4325
Mailing Address - Country:US
Mailing Address - Phone:717-972-1100
Mailing Address - Fax:
Practice Address - Street 1:12070 OLD LINE CTR
Practice Address - Street 2:SUITE 107
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2513
Practice Address - Country:US
Practice Address - Phone:301-374-6885
Practice Address - Fax:301-374-6893
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21409OtherLICENSE #
NY015514OtherPT LICENSE
DCPT870601OtherPT LICENSE