Provider Demographics
NPI:1881320281
Name:KUN, HAWA ALICE (FNP)
Entity type:Individual
Prefix:MRS
First Name:HAWA
Middle Name:ALICE
Last Name:KUN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9540 HARVEST PL
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-6067
Mailing Address - Country:US
Mailing Address - Phone:703-887-2063
Mailing Address - Fax:
Practice Address - Street 1:9255 CENTER ST
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5567
Practice Address - Country:US
Practice Address - Phone:703-887-2063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2022029815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily