Provider Demographics
NPI:1497587828
Name:POA SANA HEALTHCARE SERVICES & CONSULTANTS LLC
Entity type:Organization
Organization Name:POA SANA HEALTHCARE SERVICES & CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:P
Authorized Official - Last Name:KUTSUSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-489-6118
Mailing Address - Street 1:9497 PEP RALLY LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-3898
Mailing Address - Country:US
Mailing Address - Phone:202-489-6118
Mailing Address - Fax:
Practice Address - Street 1:2 POST OFFICE RD STE 4A
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2726
Practice Address - Country:US
Practice Address - Phone:202-489-6118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty