Provider Demographics
NPI:1801194204
Name:QUAYSON, VERA
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:
Last Name:QUAYSON
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 1:1934 OLD GALLOWS RD
Mailing Address - Street 2:#350
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-4042
Mailing Address - Country:US
Mailing Address - Phone:703-752-6109
Mailing Address - Fax:703-752-6201
Practice Address - Street 1:1934 OLD GALLOWS RD
Practice Address - Street 2:#350
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-4042
Practice Address - Country:US
Practice Address - Phone:703-752-6109
Practice Address - Fax:703-752-6201
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR151836163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse