Provider Demographics
NPI:1245889583
Name:DEVOTED HEALTHCARE SERVICES
Entity type:Organization
Organization Name:DEVOTED HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:BERTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAGANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-847-8535
Mailing Address - Street 1:9712 BELAIR RD STE 200-202
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1103
Mailing Address - Country:US
Mailing Address - Phone:410-513-7577
Mailing Address - Fax:410-497-5613
Practice Address - Street 1:9712 BELAIR RD STE 200
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-1112
Practice Address - Country:US
Practice Address - Phone:410-513-7577
Practice Address - Fax:410-497-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty