Provider Demographics
NPI:1225564628
Name:OSULA, VANESSA (DNP, RN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:OSULA
Suffix:
Gender:F
Credentials:DNP, RN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 LOUGHBORO RD NW #530
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-895-0050
Mailing Address - Fax:202-895-0051
Practice Address - Street 1:12150 ANNAPOLIS RD STE 205
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9183
Practice Address - Country:US
Practice Address - Phone:301-805-1103
Practice Address - Fax:301-805-1104
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR232351363L00000X, 363LA2200X
DCRN1047050363LA2200X, 363L00000X
MI4704286812363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology