Healthcare Provider Details

I. General information

NPI: 1255903712
Provider Name (Legal Business Name): HUI SUK KUK PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10432 BALLS FORD RD STE 300
MANASSAS VA
20109-2517
US

IV. Provider business mailing address

10432 BALLS FORD RD STE 300
MANASSAS VA
20109-2517
US

V. Phone/Fax

Practice location:
  • Phone: 571-597-5666
  • Fax: 571-597-5667
Mailing address:
  • Phone: 571-597-5666
  • Fax: 571-597-5667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024182134
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: