Provider Demographics
NPI:1790145845
Name:BHUSRY, ANANDI
Entity Type:Individual
Prefix:
First Name:ANANDI
Middle Name:
Last Name:BHUSRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GIRARD ST STE 212A
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3465
Mailing Address - Country:US
Mailing Address - Phone:301-216-0080
Mailing Address - Fax:
Practice Address - Street 1:200 GIRARD ST STE 212A
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-3465
Practice Address - Country:US
Practice Address - Phone:301-216-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196078163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse