Provider Demographics
NPI:1174111413
Name:DAUSMAN, MIRIAM RUTH (CNM)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:RUTH
Last Name:DAUSMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 VINEYARD CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8874
Mailing Address - Country:US
Mailing Address - Phone:540-422-5824
Mailing Address - Fax:
Practice Address - Street 1:2050 HILLPOINT BLVD N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-7181
Practice Address - Country:US
Practice Address - Phone:757-539-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife