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THERESA HARRINGTON STUKUS

Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1104801844

Individual Registrant:
 THERESA  HARRINGTON STUKUS 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
8318 ARLINGTON BLVD STE 305  FAIRFAX, VA 22031-5218 US
Tel: 703-207-4323  Fax: --

Contact information for business:
8318 ARLINGTON BLVD STE 305  FAIRFAX, VA 22031-5218 US
Tel: --  Fax: --

Registration Information:
NPI: 1104801844
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
VA0024165377
N2086X0206XAllopathic & Osteopathic Physicians
Surgery
DCRN61810

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RAILROAD MEDICAREP00678664DC01




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