Provider Demographics
NPI:1811646003
Name:CHASE, VIRGINIS DEBORAH
Entity type:Individual
Prefix:MS
First Name:VIRGINIS
Middle Name:DEBORAH
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 JEFFERSON HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1729
Mailing Address - Country:US
Mailing Address - Phone:301-613-4086
Mailing Address - Fax:
Practice Address - Street 1:5816 JEFFERSON HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-1729
Practice Address - Country:US
Practice Address - Phone:301-613-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant