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General NPI Number Information
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NPI Number | 1659045912
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Entity Type | Individual
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Provider Name | WENDY M CUSHING AGACNP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 330 BORTHWICK AVE STE 308
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7112
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Country | US
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Telephone | 603-431-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 5 BOND RD
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City | KITTERY POINT
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State | ME
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Zip | 03905-5614
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Country | US
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Telephone | 512-567-5219
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 050733-23
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License Number State | NH
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