Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 1918 | CA |
Y | 363L00000X | Nurse Practitioner | 20281 | CA |
NPI | 1154601987 |
---|---|
Provider Name | Meredith Kristine Tussing |
First Address | Fulton, MD 20759-2694 |
Second Address | Silver Spring, MD 20902-4053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2011 |
Last Update Date | 26/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063788200 | (05) | MD |
2482866 | COVENTRY (01) | MD |
6832-0017 | CAREFIRST (01) | MD |
8769665 | AETNA HMO (01) | MD |
9050960 | AETNA PPO (01) | MD |