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General NPI Number Information
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NPI Number | 1689648347
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Entity Type | Individual
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Provider Name | ANGELA CUSHING JUST CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3307
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Country | US
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Telephone | 703-776-3154
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Fax |
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Provider Business Mailing Address
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Address Line | 814 PARK AVE
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3101
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Country | US
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Telephone | 480-861-2803
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | RN115457
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP2177
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License Number State | AZ
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