Provider Demographics
NPI:1477112050
Name:CHIA, GERALD GWAIN (RN,MSN)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:GWAIN
Last Name:CHIA
Suffix:
Gender:M
Credentials:RN,MSN
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Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9101 CRANDALL RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1928
Mailing Address - Country:US
Mailing Address - Phone:240-595-7909
Mailing Address - Fax:
Practice Address - Street 1:5505 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4406
Practice Address - Country:US
Practice Address - Phone:240-467-4803
Practice Address - Fax:667-803-0305
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCRN1042932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health