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NPI Code Detail

MEDICARE: JUSTINE GAGNON RN

MEDICARE: JUSTINE GAGNON RN
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
1163W00000XRegistered NurseRN1030272DC

General Provider Information

NPI Number : 1235096470
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTINE GAGNON RN
Provider Business Mailing Address
First Line : 2400 JENNIFER CT
Second Line :
City : CLARKSBURG
State : MD
Zip : 20871-8530
Country : US
Telephone Number : 202-476-6783
Fax Number :
Provider Business Practice Location Address
First Line : 111 MICHIGAN AVE NW STE 4-200
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2916
Country : US
Telephone Number : 202-476-6783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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