Basic Information
| Provider Information | |||||||||
| NPI: | 1831249184 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CURTIS | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4521 ERWIN RD | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277055215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199683456 | ||||||||
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| Practice Location | |||||||||
| Address1: | TOTAL REHABILITATION, INC. 1829 EAST FRANKLIN STREET | ||||||||
| Address2: | BLDG. #600 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275143456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199683456 | ||||||||
| FaxNumber: | 9199323456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | 1692 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | BLUE CROSS | 01 | NC | 078XP | OTHER | 7226633 | 05 | NC | MEDICAID |