MEDICARE: LYNETTE KAY FUSON RN, CNS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SP0200X	Pediatric Clinical Nurse Specialist	CS00054	MD

General Provider Information

NPI Number	:	1598626624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNETTE KAY FUSON RN, CNS

Provider Business Mailing Address
First Line	:	9624 DUNDAWAN RD
Second Line	:
City	:	NOTTINGHAM
State	:	MD
Zip	:	21236-1009
Country	:	US
Telephone Number	:	410-615-9342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 ORLEANS ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0010
Country	:	US
Telephone Number	:	410-615-9342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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