Basic Information
| Provider Information | |||||||||
| NPI: | 1003801697 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PROTZMAN | ||||||||
| FirstName: | NAYDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43D MDG/SGOHA | ||||||||
| Address2: | 829 ARMISTEAD ST | ||||||||
| City: | POPE AFB | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283082383 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 43D MDG/SGOHA | ||||||||
| Address2: | 829 ARMISTEAD ST | ||||||||
| City: | POPE AFB | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283082383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103944700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW0000005962 | TN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.