Provider Demographics
NPI:1194792408
Name:TOUCH, CHHAN D (RNCS FNP)
Entity type:Individual
Prefix:
First Name:CHHAN
Middle Name:D
Last Name:TOUCH
Suffix:
Gender:M
Credentials:RNCS FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585-597 MERRIMACK ST
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-454-7685
Mailing Address - Fax:978-454-1681
Practice Address - Street 1:135 JACKSON ST
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-454-7685
Practice Address - Fax:978-454-1681
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAUX3587OtherMEDICARE PTAN
MANP4398Medicare ID - Type Unspecified
Q07060Medicare UPIN