Provider Demographics
NPI:1659045912
Name:CUSHING, WENDY M (AGACNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:CUSHING
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BOND RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY POINT
Mailing Address - State:ME
Mailing Address - Zip Code:03905-5614
Mailing Address - Country:US
Mailing Address - Phone:512-567-5219
Mailing Address - Fax:
Practice Address - Street 1:330 BORTHWICK AVE STE 308
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7112
Practice Address - Country:US
Practice Address - Phone:603-431-5242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH050733-23363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care