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THERESA HARRINGTON STUKUS
Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1104801844
Individual Registrant: THERESA HARRINGTON STUKUS
Gender: F
Not Sole Proprietor
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: --
Tel: 703-207-4323 Fax: --
Contact information for business:
8318 ARLINGTON BLVD STE 305 FAIRFAX, VA 22031-5218 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1104801844
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Adult Health | VA | 0024165377 |
| N | 2086X0206X | Allopathic & Osteopathic Physicians Surgery | DC | RN61810 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RAILROAD MEDICARE | P00678664 | DC | 01 |
