Provider Demographics
NPI:1144423534
Name:KUSZEWSKI, SANDRA F (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:F
Last Name:KUSZEWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:HOFFBERGER SUITE 52
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-7133
Mailing Address - Fax:410-601-7134
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:HOFFBERGER SUITE 52
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-7133
Practice Address - Fax:410-601-7134
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118581363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care